TY - JOUR
T1 - Computer-Based Clinical Decision Support Systems and Patient-Reported Outcomes
T2 - A Systematic Review
AU - Blum, David
AU - Raj, Sunil X
AU - Oberholzer, Rolf
AU - Riphagen, Ingrid I
AU - Strasser, Florian
AU - Kaasa, Stein
AU - EURO IMPACT, European Intersectorial Multidisciplinary Palliative Care Research Training
AU - Deliens, Luc
AU - Van den Block, Lieve
AU - De Groote, Zeger
AU - Cohen, Joachim
AU - Pardon, Koen
PY - 2015
Y1 - 2015
N2 - BACKGROUND: Evidence-based treatment guidelines embedded in computer-based clinical decision support systems (CCDSS) may improve patient-reported outcomes (PRO). We systematically reviewed the literature for content and application of CCDSS, and their effects on PRO.METHODS: A systematic review in MEDLINE and EMBASE was conducted according to PRISMA standards. Searches were limited to the publication period 1996-May 2014 and the English language. The search terms covered "computerized clinical decision systems" and "patient-reported outcomes". Screening and extraction was done independently by two reviewers according to predefined inclusion (computer and guideline) and exclusion criteria (no trial, no PRO). Study and CCDSS quality was rated according to predefined criteria.RESULTS: The database searches identified 1,331 references. Eighty-seven full-text articles were analyzed. The main reason for exclusion was no PRO as a study outcome measure. Fifteen studies met the inclusion criteria, representing 13,480 patients. Nine studies used a computerized device to fill in data; in four studies, this was used by the patients themselves. Most of the studies presented the data to the clinician at point of care and incorporated international guidelines. Three studies showed a positive effect on PRO, but only on symptoms. Overall, no negative effects were reported. There was no association with study quality or year of study publication.CONCLUSION: There are marginal positive effects of CCDSS on specific PRO. Factors that facilitate the use and effect are identified. Easy to use systems with difficult to ignore evidence-based advice need to be developed and tested.
AB - BACKGROUND: Evidence-based treatment guidelines embedded in computer-based clinical decision support systems (CCDSS) may improve patient-reported outcomes (PRO). We systematically reviewed the literature for content and application of CCDSS, and their effects on PRO.METHODS: A systematic review in MEDLINE and EMBASE was conducted according to PRISMA standards. Searches were limited to the publication period 1996-May 2014 and the English language. The search terms covered "computerized clinical decision systems" and "patient-reported outcomes". Screening and extraction was done independently by two reviewers according to predefined inclusion (computer and guideline) and exclusion criteria (no trial, no PRO). Study and CCDSS quality was rated according to predefined criteria.RESULTS: The database searches identified 1,331 references. Eighty-seven full-text articles were analyzed. The main reason for exclusion was no PRO as a study outcome measure. Fifteen studies met the inclusion criteria, representing 13,480 patients. Nine studies used a computerized device to fill in data; in four studies, this was used by the patients themselves. Most of the studies presented the data to the clinician at point of care and incorporated international guidelines. Three studies showed a positive effect on PRO, but only on symptoms. Overall, no negative effects were reported. There was no association with study quality or year of study publication.CONCLUSION: There are marginal positive effects of CCDSS on specific PRO. Factors that facilitate the use and effect are identified. Easy to use systems with difficult to ignore evidence-based advice need to be developed and tested.
KW - Databases, Bibliographic
KW - Decision Support Systems, Clinical
KW - Evidence-Based Practice
KW - Humans
KW - Patient Outcome Assessment
KW - Research Support, Non-U.S. Gov't
KW - Review
U2 - 10.1007/s40271-014-0100-1
DO - 10.1007/s40271-014-0100-1
M3 - Article
C2 - 25432150
VL - 8
SP - 397
EP - 409
JO - Patient Care
JF - Patient Care
SN - 0770-4178
IS - 5
ER -