Clinical Decision Support Systems to Improve Clinical Practice and Quality of Care

JAMA ◽  
1998 ◽  
Vol 280 (15) ◽  
pp. 1360 ◽  
Author(s):  
David C. Classen
Author(s):  
David José Murteira Mendes ◽  
Irene Pimenta Rodrigues ◽  
César Fonseca

A question answering system to help clinical practitioners in a cardiovascular healthcare environment to interface clinical decision support systems can be built by using an extended discourse representation structure, CIDERS, and an ontology framework, Ontology for General Clinical Practice. CIDERS is an extension of the well-known DRT (discourse representation theory) structures, intending to go beyond single text representation to embrace the general clinical history of a given patient represented in an ontology. The Ontology for General Clinical Practice improves the currently available state-of-the-art ontologies for medical science and for the cardiovascular specialty. The chapter shows the scientific and philosophical reasons of its present dual structure with a deeply expressive (SHOIN) terminological base (TBox) and a highly computable (EL++) assertions knowledge base (ABox). To be able to use the current reasoning techniques and methodologies, the authors made a thorough inventory of biomedical ontologies currently available in OWL2 format.


Author(s):  
David José Murteira Mendes ◽  
Irene Pimenta Rodrigues ◽  
César Fonseca

A question answering system to help clinical practitioners in a cardiovascular healthcare environment to interface clinical decision support systems can be built by using an extended discourse representation structure, CIDERS, and an ontology framework, Ontology for General Clinical Practice. CIDERS is an extension of the well-known DRT (discourse representation theory) structures, intending to go beyond single text representation to embrace the general clinical history of a given patient represented in an ontology. The Ontology for General Clinical Practice improves the currently available state-of-the-art ontologies for medical science and for the cardiovascular specialty. The chapter shows the scientific and philosophical reasons of its present dual structure with a deeply expressive (SHOIN) terminological base (TBox) and a highly computable (EL++) assertions knowledge base (ABox). To be able to use the current reasoning techniques and methodologies, the authors made a thorough inventory of biomedical ontologies currently available in OWL2 format.


2021 ◽  
pp. 019459982110045
Author(s):  
Taylor C. Standiford ◽  
Janice L. Farlow ◽  
Michael J. Brenner ◽  
Marisa L. Conte ◽  
Jeffrey E. Terrell

Objective To offer practical, evidence-informed knowledge on clinical decision support systems (CDSSs) and their utility in improving care and reducing costs in otolaryngology–head and neck surgery. This primer on CDSSs introduces clinicians to both the capabilities and the limitations of this technology, reviews the literature on current state, and seeks to spur further progress in this area. Data Sources PubMed/MEDLINE, Embase, and Web of Science. Review Methods Scoping review of CDSS literature applicable to otolaryngology clinical practice. Investigators identified articles that incorporated knowledge-based computerized CDSSs to aid clinicians in decision making and workflow. Data extraction included level of evidence, Osheroff classification of CDSS intervention type, otolaryngology subspecialty or domain, and impact on provider performance or patient outcomes. Conclusions Of 3191 studies retrieved, 11 articles met formal inclusion criteria. CDSS interventions included guideline or protocols support (n = 8), forms and templates (n = 5), data presentation aids (n = 2), and reactive alerts, reference information, or order sets (all n = 1); 4 studies had multiple interventions. CDSS studies demonstrated effectiveness across diverse domains, including antibiotic stewardship, cancer survivorship, guideline adherence, data capture, cost reduction, and workflow. Implementing CDSSs often involved collaboration with health information technologists. Implications for Practice While the published literature on CDSSs in otolaryngology is finite, CDSS interventions are proliferating in clinical practice, with roles in preventing medical errors, streamlining workflows, and improving adherence to best practices for head and neck disorders. Clinicians may collaborate with information technologists and health systems scientists to develop, implement, and investigate the impact of CDSSs in otolaryngology.


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