Preliminary evaluation of the practicability of a clinical decision support system for diagnosis and treatment of thyroid cancer (CDSS-TC) / 中华内分泌外科杂志

Objective:To study the practical efficacy of the clinical decision support system for diagnosis and treatment of thyroid cancer (CDSS-TC) in assisting doctors to complete several diagnosis and treatment tasks, and to make a preliminary evaluation of its clinical practicability according to the test results.Methods:From Jan. 2022 to Mar. 2022, 90 patients with thyroid cancer who were admitted to the Head and Neck Surgery Department of Shaw Hospital affiliated to Zhejiang University were prospectively analyzed, and the average time spent in reading the pre-operative B-ultrasound report, as well as the individual fitness of the dose adjustment of eugenol in 70 patients with thyroid cancer after surgery. A retrospective analysis was made of the compliance of the basis of the "recommended scheme" and the deviation of the basis of the doctor’s "final scheme" for the preoperative surgery of 120 patients with thyroid cancer who were treated for the first time in the head and neck surgery of Shaw Hospital affiliated to Zhejiang University from Mar. 2021 to May. 2021. All cases were treated by pure artificial (group A) and CDSS-TC assisted (group B) , and the differences in organization were compared.Results:The average time for disposal of a single B-ultrasound report in Group B was much shorter than that in Group A ( P=5.600E-04) ; The number of patients with excellent grade and the total number of patients with excellent grade and qualified grade recommended by the doctor in group B were significantly higher than those in group A ( P=7.819E-20 and P=1.335E-18) ; The conformity rate of the basis of CDSS-TC "Recommended Scheme" ≥ 98%; The deviation rate of the basis for "final protocol" of doctors in group B was lower than that in group A ( P=0.059 for total resection or not, P=0.075 for lateral neck dissection or not) . Conclusions:CDSS-TC can accurately extract the disease-related source information in all the original examination/laboratory reports, and provide accurate decision-making suggestions through efficient correlation analysis. In view of the accurate and objective conclusions of its analysis, it can provide high-quality and all-link decision support for doctors’ clinical diagnosis and treatment, and is an ideal information work platform.

Application of Standards for Semantic Interoperability in the Clinical Decision Support System / 医学信息学杂志

The paper introduces the basic situation of research on interoperability of the Clinical Decision Support System (CDSS),based on the types of standards for semantic interoperability and functional requirements for the development and arrangement of the CDSS,classifies the standards in the CDSS,and discusses the application of various standards in the CDSS.

Application of Clinical Decision Support System in Hospital / 医学信息学杂志

〔Abstract〕 Taking Wuxi People′s Hospital Affiliated to Nanjing Medical University as an example, the paper introduces the constitu-tion, software architecture and main functions of Clinical Decision Support System ( CDSS) .The system is integrated with Electronic Medical Records ( EMR) system, providing scientific and acurate information support for clinicians in the whole diagnosis process.It has positive significance to improve the work quality and reduce medical errors.

Implementation of Ontology-based Clinical Decision Support System for Management of Interactions Between Antihypertensive Drugs and Diet

PURPOSE: The influence of dietary composition on blood pressure is an important subject in healthcare. Interactions between antihypertensive drugs and diet (IBADD) is the most important factor in the management of hypertension. It is therefore essential to support healthcare providers' decision making role in active and continuous interaction control in hypertension management. The aim of this study was to implement an ontology-based clinical decision support system (CDSS) for IBADD management (IBADDM). We considered the concepts of antihypertensive drugs and foods, and focused on the interchangeability between the database and the CDSS when providing tailored information. METHODS: An ontology-based CDSS for IBADDM was implemented in eight phases: (1) determining the domain and scope of ontology, (2) reviewing existing ontology, (3) extracting and defining the concepts, (4) assigning relationships between concepts, (5) creating a conceptual map with CmapTools, (6) selecting upper ontology, (7) formally representing the ontology with Protege (ver.4.3), (8) implementing an ontology-based CDSS as a JAVA prototype application. RESULTS: We extracted 5,926 concepts, 15 properties, and formally represented them using Protege. An ontology-based CDSS for IBADDM was implemented and the evaluation score was 4.60 out of 5. CONCLUSION: We endeavored to map functions of a CDSS and implement an ontology-based CDSS for IBADDM.

Effects of Clinical Decision Support System on Reduction of Adverse Drug Events: A Meta-Analysis / 대한의료정보학회지

The adverse drug events (ADE) is not only common but also expensive. Although it was expected that ADE could be prevented by using computer-based clinical decision support system (CDSS), it is not widely accepted in the clinical field. Therefore the purpose of this study was to verify whether CDSS can reduce ADE by meta-analysis. We searched literatures by Medline from 1975 to 2002 with key words of clinical decision support system, medication error, and adverse drug event. We also searched references of review articles as well as textbooks on medical informatics. The criteria for quality evaluation were as follows: 1) the objec t were physician, nurse, pharmacist, 2) case design for CDSS analysis was pe rformed random c linical te st of experimental-control group, 3) deal with a adverse drug event organization whether or not. Among 290 retrieved articles five studies were selected for quantitative meta-analysis. The overall effect size of the risk of adverse drug event due to CDSS was calculated by common odds ratio using MetaKorea (http://www.metakorea.or.kr). Before the integration of each effect sized into common eff ect sizes the homogene ity test were conducted. All studies were ca se control design and cases were ADEs. Homogenity of studies were conducted by Mantel-Haenszel method. The chi-square is 10.78 (p<0.05). For evaluation of odds ratio, random effec t model was used. The overall odds ratio of CDSS associated with ADE was 0.315201 (95% confidence interval = 0.191411-0.519049). Our result suggested a negative association between use of CDSS and the development of serious ADE. So we concluded that the development of serious ADE was reduced using CDSS.