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Topic: Clinical decision support system

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	Chapter 53. Clinical Decision Support Systems
		Decision support systems may also help ensure a minimum standard for quality of care as part of the implementation of practice guidelines by providing patient-specific recommendations after the input of certain clinical variables.
		This combination of decision support systems and guidelines may be especially effective in conjunction with the use of the electronic medical record.
		One is a cluster randomized trial of the use of a decision support system in the treatment of patients with hypertension.
	www.ahrq.gov /clinic/ptsafety/chap53.htm (2367 words)

	Prescription Drugs > Clinical Decision System Helps Reduce Inappropriate Antimicrobial Prescribing
		A clinical decision support system intervention reduced the overall use of antimicrobials for respiratory tract infections such as colds, bronchitis and sinusitis, according to a study in the November 9 issue of JAMA.
		The PDA-based CDSS generated diagnostic and therapeutic recommendations on the basis of patient-specific information that was input about the suspected diagnosis, such as the presence or absence of specific symptoms and signs.
		The researchers found that during the second-intervention year, prescribing rates in CDSS communities decreased 10 percent from baseline, whereas in the community interventionâ“alone communities and nonstudy communities, prescribing rates in 2003 increased by 1 percent and 6 percent, respectively.
	www.emaxhealth.com /94/3698.html (675 words)

	Prerequisites for a real-time clinical decision support system
		Prerequisites for a real-time clinical decision support system
		For example, to develop a CDSS that helps a clinician interpret blood gas data, the patient’s level of respiratory support at the time of the measurement is essential.
		A data-drive mechanism in a computer system enables a knowledge engineer to set a flag so that a program can be activated when a particular type of data or data item (e.g., clinical laboratory results or a chest radiograph report) is stored in the database.
	www.informatics-review.com /thoughts/prereqs.html (689 words)

	Centre for Health Evidence
		Clinical decision analyses should be built from the perspective of the patient, that is, should include all the clinical benefits and risks of importance to patients (They can include other considerations as well).
		For a clinical decision analysis that compares two clinical strategies, there are three possible results: the first strategy is better than the second, the second strategy is better than the first, or both strategies are equally good (or equally bad), a result known as a toss-up or a close call [28].
		An article reporting a decision analysis built for a group of patients should have an analogous portion of the text, detailing the clinical characteristics of patients to whom the results of the analysis are to be applied.
	www.cche.net /principles/content_d_analysis.asp (6450 words)

	Guide to Health Informatics
		CDSS are by and large intended to support healthcare workers in the normal course of their duties, assisting with tasks that rely on the manipulation of data and knowledge.
		PDSS are usually well received because they support a pre-existing routine task, and as well as improving the quality of the clinical decision, usually offer other benefits like automated script generation and sometimes electronic transmission of the script to a pharmacy.
		The learning system is given examples of one or more drugs that weakly exhibit a particular activity, and based upon a description of the chemical structure of those compounds, the learning system suggests which of the chemical attributes are necessary for that pharmacological activity.
	www.coiera.com /aimd.htm (5070 words)

	SAS \| Customer Success: XOMA
		Using SAS for Web-enabled reporting and analysis, researchers can view clinical trial data from their desktops, even while a trial is still ongoing.
		XOMA's Clinical Decision Support System (CDSS), built with SAS/IntrNet, provides important safety and efficacy data about each of its ongoing clinical studies and also generates most of the content for the phase I CSR and most of the safety-related content for the phase II-III CSR.
		Paszty's system supports more than 500 data requests every week, providing everything from simple site data to information from a study's complex statistical analysis plan.
	www.sas.com /success/xoma.html (1013 words)

	Clinical decision support tool improves doctors' diagnostic skills in just one minute
		Isabel, a web-based clinical decision support system, prevents diagnostic errors and improves the quality of treatment decisions made by clinicians.
		It has also been shown to be a key concern of patients, a recent survey by YouGov revealing that misdiagnosis had affected 1 in 5 of the adult population in the UK and 1 in 6 in the USA.
		Assessment of the potential impact of a reminder system on the reduction of diagnostic errors: a quasi-experimental study Padmanabhan Ramnarayan, Graham C Roberts, Michael Coren, Vasantha Nanduri, Amanda Tomlinson, Paul M Taylor, Jeremy C Wyatt and Joseph F Britto
	www.eurekalert.org /pub_releases/2006-04/bc-cds042506.php (397 words)

	Mednet 2003 - 4-7 December - ISABEL: The Use of a Web-Based clinical support system
		Further decision support is provided by text, annotated images, and practice guidelines specific to each diagnosis.
		Discussion: Findings suggest that there is a small and very supportive community of devotees, including those who are involved in the development of the site, but that the website is either not sufficiently useful or not sufficiently convenient for the vast majority of users who have tried it out.
		The reasons for the latter are largely systemic to the NHS and the way it delivers its services, and would require considerable resources to make more Internet-connected computers available, and to give staff more time and opportunity to use them.
	www.hon.ch /Mednet2003/abstracts/762869647.html (968 words)

	A Computerized Clinical Decision Support System as a Means of Implementing Depression Guidelines -- Trivedi et al. 55 ...
		A Computerized Clinical Decision Support System as a Means of Implementing Depression Guidelines -- Trivedi et al.
		support systems are being used in many areas of medicine and
		systems are useful in other aspects of health care delivery.
	psychservices.psychiatryonline.org /cgi/content/full/55/8/879 (3404 words)

	Suppliers USA (Site not responding. Last check: 2007-10-27)
		Genomic Clinical System (GCS) which applies clinical algorithms to patient-specific data to identify patients at risk for genetically influenced disease; disease modules for conditions whose genetic basis can be diagnosed.
		Clinical systems for assessing and monitoring mental health conditions including PsyberCare-PC (Primary Care); tools and services to support mental health outcomes research.
		Clinical simulation tools to support training physicians, nurses, medical students and pharmacists in the diagnosis and treatment of chronic and infectious diseases.
	www.openclinical.org /suppliers.html (1654 words)

	Computerized Decision Support System Reduces Medical Errors, Cuts Costs (Site not responding. Last check: 2007-10-27)
		This 12-month randomized, prospective study of 39,462 members of QualChoice, a University Hospitals Health System healthcare plan in Cleveland, Ohio, is the first ever large-scale study of a clinical decision support system conducted in an outpatient health plan environment.
		The CareEngine System Designed to improve care, while reducing costs, the CareEngine system is the ActiveHealth patented state-of-the-art technology platform that works by creating a virtual medical record from health plan claims data, drug claims data and lab test results.
		The system continually compares this patient data to the latest evidence-based medicine and standards of care, to identify treatment opportunities for those most at risk.
	www.medicalnewstoday.com /medicalnews.php?newsid=19959&nfid=mnf (647 words)

	MIT CSAIL Clinical Decision Making Group (Site not responding. Last check: 2007-10-27)
		The Clinical Decision Making Group at the MIT Laboratory for Computer Science is a research group dedicated to exploring and furthering the application of technology and artificial intelligence to clinical situations.
		Because of the vital and crucial nature of medical practice, and the need for accurate and timely information to support clinical decisions, the group is also focused on the gathering, availability, security and use of medical information throughout the human "life cycle" and beyond.
		Developing tools and techniques to "read" unstructured English descriptions of clinical data and knowledge.
	www.medg.lcs.mit.edu (186 words)

	MGH Laboratory of Computer Science
		The LCS provides clinical and research information systems support to the hospital and conducts active research into the application of computer technology to medical record systems, physician workstations, clinical problem solving, expert systems in medical diagnosis (e.g., DXplain®), knowledge management, and clinical research.
		DXplain is a decision support system which uses a set of clinical findings (signs, symptoms, laboratory data) to produce a ranked list of diagnoses which might explain (or be associated with) the clinical manifestations.
		DXplain provides justification for why each of these diseases might be considered, suggests what further clinical information would be useful to collect for each disease, and lists what clinical manifestations, if any, would be unusual or atypical for each of the specific diseases.
	www.lcs.mgh.harvard.edu (230 words)

	Logical Images - VisualDx - Clinical Decision Support Software
		VisualDx is a breakthrough system designed to give general practitioners the diagnostic expertise of specialists.
		To use the technology, clinicians enter their patient's symptoms and other clinical findings such as lesion type, body location, medical history, medications, etc., then the system displays photographs and key clinical information on all relevant diagnoses for quick, side-by-side comparison to their patient.
		Now with the added switch module capability, the system lets you toggle between modules while preserving captured patient findings to quickly compare diagnoses or to simply jump into another module.
	www.logicalimages.com /prodVDx.htm (237 words)

	InferMed - Clinical trial software, remote data entry, clinical decision support, clinical guidelines
		The AREZZO clinical decision support software enables the design, creation, and execution of clinical guidelines and patient care protocols that guide medical professionals with advice tailored for each patient individually.
		AREZZO guides the user through the collection of that data which will assist in making decisions about the optimum clinical actions that should be taken in complex patient care situations.
		Specifically for Oracle® Clinical users, Clinical Gateway bridges the gap between remote data entry and Oracle® Clinical, delivering integration of study definition, patient data and discrepancies between Oracle® Clinical and MACRO.
	www.infermed.com (353 words)

	Evaluation of computer based clinical decision support system and risk chart for management of hypertension in primary ... (Site not responding. Last check: 2007-10-27)
		Evaluation of computer based clinical decision support system and risk chart for management of hypertension in primary care: randomised controlled trial -- Montgomery et al.
		The clinical importance of the reduction in systolic blood pressure in the chart group (4.6 mm Hg) should be interpreted in
		Computer based clinical decision support systems have been shown to improve preventive care, but it is unclear whether they affect blood pressure and cardiovascular risk
	www.bmj.com /cgi/content/full/320/7236/686 (3423 words)

	Clinical Decision Support Systems: Perspectives in Dentistry -- Mendonça 68 (6): 589 -- Journal of Dental ...
		The evoke slot defines the situation that causes the rule to be triggered (serum digoxin level); the logic slot encodes the decision logic of the rule; and the action slot defines the procedure to follow if a positive conclusion is reached.
		Pretherapy dental decisions in patients with head and neck cancer: a proposed model for dental decision support.
		Clinical decision support systems for the practice of evidence-based medicine.
	www.jdentaled.org /cgi/content/full/68/6/589 (3838 words)

	Decision support and safety of clinical environments -- Morris 11 (1): 69 -- Quality and Safety in Health Care
		Systems can be configured to support human decision makers.
		Clinical and regulatory implications of the cardiac arrhythmia suppression trial (editorial).
		Effects of computer-based clinical decision support systems on clinician performance and patient outcome.
	qhc.bmjjournals.com /cgi/content/full/11/1/69 (4818 words)

	InformationWeek \| Health-Care IT \| Software Aggregates Medical Knowledge In Hopes Of Averting Misdiagnoses \| December ...
		Thus was born the Isabel pediatric diagnostic system.
		With minimal input from clinicians, the system prompts physicians to consider a range of different diagnoses, some of which might not be immediately apparent, particularly to less experienced professionals.
		Only a few months after launch, the system had 20,000 users from more than 100 countries, according to Isabel Healthcare Ltd., a commercial subsidiary owned by the Isabel charity that has taken over development and commercialization of the diagnostic system.
	www.informationweek.com /showArticle.jhtml?articleID=56200189 (968 words)

	Compliance of General Practitioners with a Guideline-based Decision Support System for Ordering Blood Tests -- van Wijk ...
		in 14 of 18 systems in which it was measured.
		Role of clinical practice guidelines and clinical profiling in facilitating optimal laboratory use.
		A template-based approach to support utilization of clinical practice guidelines within a electronic record.
	www.clinchem.org /cgi/content/full/48/1/55 (3212 words)

	Thomson - Environmental Health & Public Safety
		The RegsKnowledge® System is a single, comprehensive resource to help answer all your regulatory compliance questions.
		No one can predict which toxins will be released, but this fundamental reference will arm you with the essential facts you need to cope with over 50 of the most likely possibilities—outlining the telltale signs and symptoms of each, and summarizing the appropriate clinical response.
		With Thomson Clinical Xpert™, clinicians can access over 2,000 abbreviated drug monographs covering more than 4,000 formulations and download daily updates on drug recalls, labeling changes, new drug approvals, and more.
	www.thomson.com /solutions/healthcare/health_safety (353 words)

	Computerized Physician Order Entry and Online Decision Support -- Handler et al. 11 (11): 1135 -- Academic Emergency ...
		Decisions regarding CPOE and DSS in the ED should be guided by the ED chair or designee.
		Implementation of clinical guidelines via a computer charting system: effect on the care of febrile children less than three years of age.
		Web-based clinical decision support system for triage of vestibular patients.
	www.aemj.org /cgi/content/full/11/11/1135 (3522 words)

	Visualmed Solutions
		An emerging trend is developing in the government sector, with legislatures in France, Australia, Canada and several of the the United States developing consensus and legislation pushing forward an agenda that sees the rationalization of healthcare practice.
		This rationalization is accomplished by making available to clinicians information stored in heretofore disparate non-communicating information systems, while integrating the documentation of care into a uniform electronic medical record easily accessed by caregivers both locally and regionally.
		VisualMED Clinical Solutions Corporation was established in 2004 with the sole purpose of marketing state-of-the-art Clinical Information Systems (CIS) to healthcare institutions, based on a robust core CPOE engine conceived by clinicians, integrated within a comprehensive patient electronic medical record.
	www.visualmedsolutions.com (330 words)

	Evaluation of a Computerized Diagnostic Decision Support System for Patients with Pneumonia: Study Design ...
		Evaluation of a Computerized Diagnostic Decision Support System for Patients with Pneumonia: Study Design Considerations -- Aronsky et al.
		Evaluation of a Computerized Diagnostic Decision Support System for Patients with Pneumonia
		Improving clinical practice using clinical decision support systems: a systematic review of trials to identify features critical to success
	www.jamia.org /cgi/content/abstract/8/5/473 (390 words)

	Supporting Clinical Practice at the Bedside Using Wireless Technology -- Bullard et al. 11 (11): 1186 -- Academic ...
		Supporting Clinical Practice at the Bedside Using Wireless Technology -- Bullard et al.
		Computerized decision support based on clinical practice guideline improves compliance with care standards.
		Repeated measures in clinical trials: analysis using mean summary statistics and its implications for design.
	www.aemj.org /cgi/content/full/11/11/1186 (3435 words)

	TheraDoc's Clinical Decision Support Software Live At VA Salt Lake City Health Care System; Clinical use of TheraDoc's ... (Site not responding. Last check: 2007-10-27)
		According to a 2004 report by Nicholas Graves, M.D., in the CDC's Emerging Infectious Diseases Journal, the effect of infectious diseases is one of the largest cost drivers in U.S. hospitals with annual economic costs of $6.7 billion (in 2002 dollars).
		TheraDoc is a medical informatics company specializing in therapeutic, real-time decision support that improves the quality, safety, and efficiency of patient care in large and small healthcare organizations.
		Their experience in clinical decision support design and development spans two decades.
	www.forbes.com /businesswire/feeds/businesswire/2005/05/16/businesswire20050516005302r1.html (1028 words)

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