PP145 VALIDATE Methodology For A Medication-Related Clinical Decision Support System: Innovating Or Going Back To Basics?

2021 ◽  
Vol 37 (S1) ◽  
pp. 21-22
Author(s):  
Carla Fernandez-Barceló ◽  
Elena Calvo-Cidoncha ◽  
Laura Sampietro-Colom
Keyword(s):  
Decision Making ◽  
Decision Support ◽  
Decision Support System ◽  
Clinical Decision Support ◽  
Support System ◽  
Clinical Decision Support System ◽  
Clinical Decision ◽  
Health Technology ◽  
Problem Definition ◽  
Cochrane Library

IntroductionIn the past decade, health technology assessment (HTA) has narrowed its scope to the analysis of mainly clinical and economic benefits. However, twenty-first century technology challenges require the need for more holistic assessments to obtain accurate recommendations for decision-making, as it was in HTA's foundations. VALues In Doing Assessments of health TEchnologies (VALIDATE) methodology approaches complex technologies holistically to provide a deeper understanding of the problem through analysis of the heterogeneity of stakeholders’ views, allowing for more comprehensive HTAs. This study aimed to assess a pharmaceutical clinical decision support system (CDSS) using VALIDATE.MethodsA systematic review of the empirical evidence on CDSS was conducted according to PRISMA guidelines. PubMed, the Cochrane Library, and Web of Science databases were searched for literature published between 2000 and 2020. Additionally, a review of grey literature and semi-structured interviews with different hospital stakeholders (pharmacists, physicians, computer engineers, etc.) were conducted. Content analysis was used for data integration.ResultsPreliminary literature results indicated consensus regarding the effectiveness of CDSS. Nevertheless, when including multistakeholder views, CDSS appeared to not be fully accepted in clinical practice. The main reasons for this appeared to be alert fatigue and disruption of workflow. Preliminary results based on information from the literature were contrasted with stakeholder interview responses.ConclusionsIncorporation of facts and stakeholder values into the problem definition and scoping for a health technology is essential to properly conduct HTAs. The lack of an inclusive multistakeholder scoping can lead to inaccurate information, and in this particular case to suboptimal CDSS implementation concerning decision-making for the technology being evaluated.

scholarly journals A Clinical Decision Support System based on Ontology and Causal Reasoning Models

2019 ◽  
Vol 14 (2) ◽  
pp. 187-197
Author(s):  
Nur Raidah Rahim ◽  
Sharifalillah Nordin ◽  
Rosma Mohd Dom
Keyword(s):  
Decision Making ◽  
Decision Support ◽  
Decision Support System ◽  
Clinical Decision Support ◽  
Support System ◽  
Clinical Decision Support System ◽  
Causal Reasoning ◽  
Clinical Decision ◽  
Decision Making Process ◽  
Graphical Modeling

  Clinical decision support system (CDSS) is promising in assisting physicians for improving decision-making process and facilitates healthcare services. In medicine, causality has become the main concern throughout healthcare and decision-making. Causality is necessary for understanding all structures ofscientific reasoning and for providing a coherent and sufficient explanation for any event. However, thereare lack of existing CDSS that provide causal reasoning for the presented outcomes or decisions. Theseare necessary for showing reliability of the outcomes, and helping the physicians in making properdecisions. In this study, an ontology-based CDSS model is developed based on several key concepts andfeatures of causality and graphical modeling techniques. For the evaluation process, the Pellet reasoneris used to evaluate the consistency of the developed ontology model. In addition, an evaluation toolknown as Ontology Pitfall Scanner is used for validating the ontology model through pitfalls detection.The developed ontology-based CDSS model has potentials to be applied in clinical practice and helpingthe physicians in decision-making process. Keywords: clinical decision support system, ontology, causality, causal reasoning, graphical modeling

A structural design of clinical decision support system for chronic diseases risk management

Open Medicine ◽  
2007 ◽  
Vol 2 (2) ◽  
pp. 129-139 ◽  
Author(s):  
Chi-Chang Chang ◽  
Chuen-Sheng Cheng
Keyword(s):  
Decision Making ◽  
Risk Management ◽  
Decision Support ◽  
Decision Support System ◽  
Clinical Decision Support ◽  
Support System ◽  
Structural Design ◽  
Clinical Decision Support System ◽  
Clinical Decision Making ◽  
Clinical Decision

AbstractIn clinical decision making, the event of primary interest is recurrent, so that for a given unit the event could be observed more than once during the study. In general, the successive times between failures of human physiological systems are not necessarily identically distributed. However, if any critical deterioration is detected, then the decision of when to take thei ntervention, given the costs of diagnosis and therapeutics, is of fundamental importance This paper develops a possible structural design of clinical decision support system (CDSS) by considering the sensitivity analysis as well as the optimal prior and posterior decisions for chronic diseases risk management. Indeed, Bayesian inference of a nonhomogeneous Poisson process with three different failure models (linear, exponential, and power law) were considered, and the effects of the scale factor and the aging rate of these models were investigated. In addition, we illustrate our method with an analysis of data from a trial of immunotherapy in the treatment of chronic granulomatous disease. The proposed structural design of CDSS facilitates the effective use of the computing capability of computers and provides a systematic way to integrate the expert’s opinions and the sampling information which will furnish decision makers with valuable support for quality clinical decision making.

Clinical Decision Support System for Diabetes Prevention

2013 ◽  
pp. 308-329 ◽  
Author(s):  
Sarin Shrestha
Keyword(s):  
Decision Making ◽  
Decision Support ◽  
Decision Support System ◽  
Clinical Decision Support ◽  
Support System ◽  
Diabetes Prevention ◽  
Clinical Decision Support System ◽  
Clinical Decision ◽  
Healthcare Data ◽  
The Right

Millions of people around the world have diabetes. It is the seventh leading cause of death in US. An advancement of technologies may serve as the backbone for controlling diseases. Computerizing healthcare is expected to be one of the powerful levers essential for significant transformation in the quality and cost of delivering healthcare. Data management and technology is essential for providing the ability to exchange data and information at the right place in the right time to the right people in the healthcare process, to enable informed decision-making, and to achieve better health outcomes. Clinical Decision Support System (CDSS) provides guidance specific to the patient, including importing/entering patient data into the CDSS application and providing relevant information like lists of possible diagnoses, drug interaction alerts, or preventive care reminders to the practitioner that assists in their decision-making. This chapter has focuses on the use of CDSS for diabetes prevention.

1309-P: Utilizing a Clinical Decision Support System for Hypoglycemia Management

Diabetes ◽  
2019 ◽  
Vol 68 (Supplement 1) ◽  
pp. 1309-P
Author(s):  
JACQUELYN R. GIBBS ◽  
KIMBERLY BERGER ◽  
MERCEDES FALCIGLIA
Keyword(s):  
Decision Support ◽  
Decision Support System ◽  
Clinical Decision Support ◽  
Support System ◽  
Clinical Decision Support System ◽  
Clinical Decision

A Clinical Decision Support System for Assessing the Risk of Cardiovascular Diseases in Diabetic Hemodialysis Patients

2020 ◽  
Vol 16 (3) ◽  
pp. 262-269
Author(s):  
Tahere Talebi Azad Boni ◽  
Haleh Ayatollahi ◽  
Mostafa Langarizadeh
Keyword(s):  
Decision Support ◽  
Cardiovascular Diseases ◽  
Decision Support System ◽  
Clinical Decision Support ◽  
Support System ◽  
Clinical Decision Support System ◽  
Clinical Decision ◽  
Diabetic Patients ◽  
K Value ◽  
Care Plans

Background: One of the greatest challenges in the field of medicine is the increasing burden of chronic diseases, such as diabetes. Diabetes may cause several complications, such as kidney failure which is followed by hemodialysis and an increasing risk of cardiovascular diseases. Objective: The purpose of this research was to develop a clinical decision support system for assessing the risk of cardiovascular diseases in diabetic patients undergoing hemodialysis by using a fuzzy logic approach. Methods: This study was conducted in 2018. Initially, the views of physicians on the importance of assessment parameters were determined by using a questionnaire. The face and content validity of the questionnaire was approved by the experts in the field of medicine. The reliability of the questionnaire was calculated by using the test-retest method (r = 0.89). This system was designed and implemented by using MATLAB software. Then, it was evaluated by using the medical records of diabetic patients undergoing hemodialysis (n=208). Results: According to the physicians' point of view, the most important parameters for assessing the risk of cardiovascular diseases were glomerular filtration, duration of diabetes, age, blood pressure, type of diabetes, body mass index, smoking, and C reactive protein. The system was designed and the evaluation results showed that the values of sensitivity, accuracy, and validity were 85%, 92% and 90%, respectively. The K-value was 0.62. Conclusion: The results of the system were largely similar to the patients’ records and showed that the designed system can be used to help physicians to assess the risk of cardiovascular diseases and to improve the quality of care services for diabetic patients undergoing hemodialysis. By predicting the risk of the disease and classifying patients in different risk groups, it is possible to provide them with better care plans.

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