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Titolo:
Evaluating informatics applications - clinical decision support systems literature review
Autore:
Kaplan, B;
Indirizzi:
Yale Univ, Sch Med, Ctr Med Informat, New Haven, CT USA Yale Univ New Haven CT USA Sch Med, Ctr Med Informat, New Haven, CT USA
Titolo Testata:
INTERNATIONAL JOURNAL OF MEDICAL INFORMATICS
fascicolo: 1, volume: 64, anno: 2001,
pagine: 15 - 37
SICI:
1386-5056(200111)64:1<15:EIA-CD>2.0.ZU;2-I
Fonte:
ISI
Lingua:
ENG
Soggetto:
PREVENTIVE CARE GUIDELINES; MEDICAL EXPERT SYSTEMS; PHYSICIAN ORDER ENTRY; ADVERSE DRUG EVENTS; HEALTH-CARE; DIAGNOSTIC SYSTEMS; CONTROLLED TRIALS; PATIENT OUTCOMES; COMPUTER; PERFORMANCE;
Keywords:
evaluation; decision support; CDSS; clinical decision support systems; clinical practice guidelines; randomized controlled clinical trials;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Life Sciences
Citazioni:
89
Recensione:
Indirizzi per estratti:
Indirizzo: Kaplan, B Kaplan Associates, 59 Morris St, Hamden, CT 06517 USA Kaplan Associates 59 Morris St Hamden CT USA 06517 CT 06517 USA
Citazione:
B. Kaplan, "Evaluating informatics applications - clinical decision support systems literature review", INT J MED I, 64(1), 2001, pp. 15-37

Abstract

This paper reviews clinical decision support systems (CDSS) literature, with a focus on evaluation. The literature indicates a general consensus thatclinical decision support systems are thought to have the potential to improve care. Evidence is more equivocal for guidelines and for systems to aidphysicians with diagnosis. There also is general consensus that a variety of systems are little used despite demonstrated or potential benefits. In the evaluation literature, the main emphasis is on how clinical performance changes. Most studies use an experimental or randomized controlled clinicaltrials design (RCT) to assess system performance or to focus on changes inclinical performance that could affect patient care. Few studies involve field tests of a CDSS and almost none use a naturalistic design in routine clinical settings with real patients. In addition, there is little theoretical discussion, although papers are permeated by a rationalist perspective that excludes contextual issues related to how and why systems are used. Thestudies mostly concern physicians rather than other clinicians. Further, CDSS evaluation studies appear to be insulated from evaluations of other informatics applications: Consequently, there is a lack of information useful for understanding why CDSSs may or may not be effective, resulting in making less informed decisions about these technologies and, by extension, othermedical informatics applications. (C) 2001 Published by Elsevier Science Ireland Ltd.

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Documento generato il 06/04/20 alle ore 04:00:37