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NIH | National Heart, Lung, and Blood Institute"},{"name":"U.S. Department of Health & Human Services | NIH | National Human Genome Research Institute"},{"name":"U.S. Department of Health & Human Services | NIH | National Heart, Lung, and Blood Institute"},{"name":"U.S. Department of Health & Human Services | NIH | National Heart, Lung, and Blood Institute"},{"name":"U.S. Department of Health & Human Services | NIH | National Human Genome Research Institute"},{"name":"U.S. Department of Health & Human Services | NIH | National Heart, Lung, and Blood Institute"},{"name":"U.S. Department of Health & Human Services | NIH | National Heart, Lung, and Blood Institute"},{"name":"U.S. Department of Health & Human Services | NIH | National Human Genome Research Institute"},{"name":"U.S. Department of Health & Human Services | NIH | National Heart, Lung, and Blood Institute"},{"name":"U.S. Department of Health & Human Services | NIH | National Heart, Lung, and Blood Institute"},{"name":"U.S. Department of Health & Human Services | NIH | National Human Genome Research Institute"},{"name":"U.S. Department of Health & Human Services | NIH | National Heart, Lung, and Blood Institute"},{"name":"U.S. Department of Health & Human Services | NIH | National Heart, Lung, and Blood Institute"},{"name":"U.S. Department of Health & Human Services | NIH | National Human Genome Research Institute"},{"name":"U.S. Department of Health & Human Services | NIH | National Heart, Lung, and Blood Institute"},{"name":"U.S. Department of Health & Human Services | NIH | National Heart, Lung, and Blood Institute"},{"name":"U.S. Department of Health & Human Services | NIH | National Human Genome Research Institute"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["npj Digit. Med."],"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Severe hypercholesterolemia\/possible familial hypercholesterolemia (FH) is relatively common but underdiagnosed and undertreated. We investigated whether implementing clinical decision support (CDS) was associated with lower low-density lipoprotein cholesterol (LDL-C) in patients with severe hypercholesterolemia\/possible FH (LDL-C\u2009\u2265\u2009190\u2009mg\/dL). As part of a pre-post implementation study, a CDS alert was deployed in the electronic health record (EHR) in a large health system comprising 3 main sites, 16 hospitals and 53 clinics. Data were collected for 3 months before (\u2018silent mode\u2019) and after (\u2018active mode\u2019) its implementation. Clinicians were only able to view the alert in the EHR during active mode. We matched individuals 1:1 in both modes, based on age, sex, and baseline lipid lowering therapy (LLT). The primary outcome was difference in LDL-C between the two groups and the secondary outcome was initiation\/intensification of LLT after alert trigger. We identified 800 matched patients in each mode (mean\u2009\u00b1\u2009SD age 56.1\u2009\u00b1\u200911.8\u2009y vs. 55.9\u2009\u00b1\u200911.8\u2009y; 36.0% male in both groups; mean\u2009\u00b1\u2009SD initial LDL-C 211.3\u2009\u00b1\u200927.4\u2009mg\/dL vs. 209.8\u2009\u00b1\u200923.9\u2009mg\/dL; 11.2% on LLT at baseline in each group). LDL-C levels were 6.6\u2009mg\/dL lower (95% CI, \u221210.7 to \u22122.5; <jats:italic>P<\/jats:italic>\u2009=\u20090.002) in active vs. silent mode. The odds of high-intensity statin use (OR, 1.78; 95% CI, 1.41\u20132.23; <jats:italic>P<\/jats:italic>\u2009&lt;\u20090.001) and LLT initiation\/intensification (OR, 1.30, 95% CI, 1.06\u20131.58, <jats:italic>P<\/jats:italic>\u2009=\u20090.01) were higher in active vs. silent mode. Implementation of a CDS was associated with lowering of LDL-C levels in patients with severe hypercholesterolemia\/possible FH, likely due to higher rates of clinician led LLT initiation\/intensification.<\/jats:p>","DOI":"10.1038\/s41746-024-01069-w","type":"journal-article","created":{"date-parts":[[2024,3,18]],"date-time":"2024-03-18T15:02:31Z","timestamp":1710774151000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Effect of clinical decision support for severe hypercholesterolemia on low-density lipoprotein cholesterol levels"],"prefix":"10.1038","volume":"7","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2552-9499","authenticated-orcid":false,"given":"Hana","family":"Bangash","sequence":"first","affiliation":[]},{"given":"Seyedmohammad","family":"Saadatagah","sequence":"additional","affiliation":[]},{"given":"Mohammadreza","family":"Naderian","sequence":"additional","affiliation":[]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1299-9969","authenticated-orcid":false,"given":"Marwan E.","family":"Hamed","sequence":"additional","affiliation":[]},{"given":"Lubna","family":"Alhalabi","sequence":"additional","affiliation":[]},{"given":"Alborz","family":"Sherafati","sequence":"additional","affiliation":[]},{"given":"Joseph","family":"Sutton","sequence":"additional","affiliation":[]},{"given":"Omar","family":"Elsekaily","sequence":"additional","affiliation":[]},{"given":"Ali","family":"Mir","sequence":"additional","affiliation":[]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7347-0511","authenticated-orcid":false,"given":"Justin H.","family":"Gundelach","sequence":"additional","affiliation":[]},{"given":"Daniel","family":"Gibbons","sequence":"additional","affiliation":[]},{"given":"Paul","family":"Johnsen","sequence":"additional","affiliation":[]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4561-4404","authenticated-orcid":false,"given":"Christina M.","family":"Wood-Wentz","sequence":"additional","affiliation":[]},{"given":"Carin Y.","family":"Smith","sequence":"additional","affiliation":[]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9050-7080","authenticated-orcid":false,"given":"Pedro J.","family":"Caraballo","sequence":"additional","affiliation":[]},{"given":"Kent R.","family":"Bailey","sequence":"additional","affiliation":[]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6524-3471","authenticated-orcid":false,"given":"Iftikhar J.","family":"Kullo","sequence":"additional","affiliation":[]}],"member":"297","published-online":{"date-parts":[[2024,3,18]]},"reference":[{"key":"1069_CR1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajpc.2022.100393","volume":"12","author":"S Saadatagah","year":"2022","unstructured":"Saadatagah, S. et al. 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