{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2024,7,9]],"date-time":"2024-07-09T17:13:48Z","timestamp":1720545228356},"reference-count":67,"publisher":"Oxford University Press (OUP)","issue":"e1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2015,4,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p>Clinical decision support systems (CDSSs) assist clinicians with patient diagnosis and treatment. However, inadequate attention has been paid to the process of selecting and buying systems. The diversity of CDSSs, coupled with research obstacles, marketplace limitations, and legal impediments, has thwarted comparative outcome studies and reduced the availability of reliable information and advice for purchasers. We review these limitations and recommend several comparative studies, which were conducted in phases; studies conducted in phases and focused on limited outcomes of safety, efficacy, and implementation in varied clinical settings. Additionally, we recommend the increased availability of guidance tools to assist purchasers with evidence-based purchases. Transparency is necessary in purchasers\u2019 reporting of system defects and vendors\u2019 disclosure of marketing conflicts of interest to support methodologically sound studies. Taken together, these measures can foster the evolution of evidence-based tools that, in turn, will enable and empower system purchasers to make wise choices and improve the care of patients.<\/jats:p>","DOI":"10.1093\/jamia\/ocu033","type":"journal-article","created":{"date-parts":[[2015,2,10]],"date-time":"2015-02-10T01:25:53Z","timestamp":1423531553000},"page":"e13-e20","source":"Crossref","is-referenced-by-count":2,"title":["Comparative outcome studies of clinical decision support software: limitations to the practice of evidence-based system acquisition"],"prefix":"10.1093","volume":"22","author":[{"given":"Gaurav Jay","family":"Dhiman","sequence":"first","affiliation":[{"name":"University of Miami Miller School of Medicine, Miami, FL, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kyle T","family":"Amber","sequence":"additional","affiliation":[{"name":"University of Miami Miller School of Medicine, Miami, FL, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kenneth W.","family":"Goodman","sequence":"additional","affiliation":[{"name":"Bioethics Program, University of Miami Miller School of Medicine, Miami, FL, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2015,2,9]]},"reference":[{"key":"2020110612593113800_ocu033-B1","volume-title":"What is Clinical Decision Support (CDS)?","author":"Office of the National Coordinator for Health Information Technology","year":"2013"},{"key":"2020110612593113800_ocu033-B2","volume-title":"Healthcare Information Technology Standards Panel","author":"Healthcare Information Technology Standards Panel (HITSP)","year":"2009"},{"key":"2020110612593113800_ocu033-B3","first-page":"1","volume-title":"Clinical Decision Support Systems: State of the Art","author":"Berner","year":"2009"},{"key":"2020110612593113800_ocu033-B4","doi-asserted-by":"crossref","first-page":"29","DOI":"10.7326\/0003-4819-157-1-201207030-00450","article-title":"Effect of clinical decision-support systems: a systematic review","volume":"157","author":"Bright","year":"2012","journal-title":"Ann Intern Med."},{"key":"2020110612593113800_ocu033-B5","first-page":"38","article-title":"Implementation pearls from a new guidebook on improving medication use and outcomes with clinical decision support: effective CDS is essential for addressing healthcare performance improvement imperatives","volume":"23","author":"Sirajuddin","year":"2009","journal-title":"J Healthc Inform Manag."},{"key":"2020110612593113800_ocu033-B6","doi-asserted-by":"crossref","first-page":"77","DOI":"10.1136\/jamia.2010.008946","article-title":"AMIA Board of Directors Challenges in ethics, safety, best practices, and oversight regarding HIT vendors, their customers, and patients: a report of an AMIA special task force","volume":"18","author":"Goodman","year":"2011","journal-title":"J Am Med Inform Assoc."},{"key":"2020110612593113800_ocu033-B7","doi-asserted-by":"crossref","first-page":"2310","DOI":"10.1377\/hlthaff.2010.1111","article-title":"Clinical decision support systems could be modified to reduce \u2018alert fatigue\u2019 while still minimizing the risk of litigation","volume":"30","author":"Kesselheim","year":"2011","journal-title":"Health Aff."},{"key":"2020110612593113800_ocu033-B8","doi-asserted-by":"crossref","first-page":"e1042","DOI":"10.1542\/peds.2010-2184","article-title":"Legal, ethical, and financial dilemmas in electronic health record adoption and use","volume":"127","author":"Sittig","year":"2011","journal-title":"Pediatrics."},{"key":"2020110612593113800_ocu033-B9","doi-asserted-by":"crossref","first-page":"429","DOI":"10.1136\/jamia.1996.97084516","article-title":"Evaluating evaluations of medical diagnostic systems","volume":"3","author":"Miller","year":"1996","journal-title":"J Am Med Inform Assoc."},{"key":"2020110612593113800_ocu033-B10","first-page":"257","article-title":"Too many alerts, too much liability: sorting through the malpratice implications of drug-drug interaction clinical decision support","volume":"5","author":"Ridgley","year":"2012","journal-title":"St. Louis U. J. Health L. & Pol'y."},{"key":"2020110612593113800_ocu033-B11","first-page":"219","article-title":"How to select a clinical information system","volume":"2001","author":"Graeber","year":"2001","journal-title":"Proc AMIA Annu Symp."},{"issue":"1","key":"2020110612593113800_ocu033-B12","doi-asserted-by":"crossref","first-page":"29","DOI":"10.1197\/jamia.M2170","article-title":"Medication-related clinical decision support in computerized provider order entry systems: a review","volume":"14","author":"Kuperman","year":"2007","journal-title":"J Am Med Inform Assoc."},{"key":"2020110612593113800_ocu033-B13","first-page":"523","article-title":"Ten commandments for effective clinical decision support: making the practice of evidence-based medicine a reality","volume":"13","author":"Bates","year":"2006","journal-title":"J Am Med Inform Assoc."},{"key":"2020110612593113800_ocu033-B14","first-page":"3","volume-title":"Clinical Decision Support Implementers\u2019 Workbook","author":"Osheroff","year":"2004","edition":"2nd ed."},{"key":"2020110612593113800_ocu033-B15"},{"key":"2020110612593113800_ocu033-B16","volume-title":"Clinical Decision Support Work Group","author":"Health Level Seven, Inc.","year":"2009"},{"key":"2020110612593113800_ocu033-B17"},{"key":"2020110612593113800_ocu033-B18"},{"key":"2020110612593113800_ocu033-B19","volume-title":"Clinical Decision Support","author":"Teich","year":"2014"},{"key":"2020110612593113800_ocu033-B20","doi-asserted-by":"crossref","first-page":"637","DOI":"10.1197\/jamia.M3111","article-title":"Clinical decision support capabilities of commercially-available clinical information systems","volume":"16","author":"Wright","year":"2009","journal-title":"J Am Med Inform Assoc."},{"key":"2020110612593113800_ocu033-B21","doi-asserted-by":"crossref","first-page":"232","DOI":"10.1136\/amiajnl-2011-000113","article-title":"Development and evaluation of a comprehensive clinical decision taxonomy: comparison of front-end tools in commercial and internally developed electronic health record systems","volume":"18","author":"Wright","year":"2011","journal-title":"J Am Med Inform Assoc."},{"key":"2020110612593113800_ocu033-B22","doi-asserted-by":"crossref","first-page":"1792","DOI":"10.1056\/NEJM199406233302506","article-title":"Performance of four computer-based diagnostic systems","volume":"330","author":"Berner","year":"1994","journal-title":"N Eng J Med."},{"key":"2020110612593113800_ocu033-B23","doi-asserted-by":"crossref","first-page":"208","DOI":"10.1136\/jamia.1996.96310634","article-title":"Relationships among performance scores of four diagnostic decision support systems","volume":"3","author":"Berner","year":"1996","journal-title":"J Am Med Inform Assoc."},{"key":"2020110612593113800_ocu033-B24","doi-asserted-by":"crossref","first-page":"334","DOI":"10.1016\/j.jbi.2008.09.003","article-title":"Creating and sharing clinical decision support content with web 2.0: issues and examples","volume":"42","author":"Wright","year":"2009","journal-title":"J Biomed Inform."},{"key":"2020110612593113800_ocu033-B25","doi-asserted-by":"crossref","first-page":"284","DOI":"10.4338\/ACI-2011-02-RA-0012","article-title":"Comparison of computer-based clinical decision support systems and content for diabetes mellitus","volume":"2","author":"Kantor","year":"2011","journal-title":"Appl Clin Inform."},{"key":"2020110612593113800_ocu033-B26","first-page":"378","article-title":"Computerized clinical decision-support in respiratory care","volume":"49","author":"Gardner","year":"2004","journal-title":"Respir Care."},{"key":"2020110612593113800_ocu033-B27","doi-asserted-by":"crossref","first-page":"13","DOI":"10.1186\/1472-6947-11-13","article-title":"Comparison of clinical knowledge management capabilities of commercially-available and leading internally-developed electronic health records","volume":"11","author":"Sittig","year":"2011","journal-title":"BMC Med Inform Decis Mak."},{"key":"2020110612593113800_ocu033-B28","doi-asserted-by":"crossref","first-page":"92","DOI":"10.1186\/1748-5908-6-92","article-title":"Computerized clinical decision support systems for chronic disease management: a decision-maker-researcher partnership systematic review","volume":"6","author":"Roshanov","year":"2011","journal-title":"Implement Sci."},{"key":"2020110612593113800_ocu033-B29"},{"key":"2020110612593113800_ocu033-B30","doi-asserted-by":"crossref","first-page":"369","DOI":"10.1197\/jamia.M2055","article-title":"Using commerical knowledge bases for clinical decision support: opportunities, hurdles, and recommendations","volume":"13","author":"Kuperman","year":"2006","journal-title":"J Am Med Inform Assoc."},{"key":"2020110612593113800_ocu033-B31","article-title":"Effective use of medication-related decision support in CPOE","volume-title":"Patient Safety & Quality Healthcare","author":"Metzger","year":"2008"},{"key":"2020110612593113800_ocu033-B32","doi-asserted-by":"crossref","first-page":"111","DOI":"10.1186\/1472-6947-13-111","article-title":"On the alert: future priorities for alerts in clinical decision support for computerized physician order entry identified by a European workshop","volume":"13","author":"Coleman","year":"2013","journal-title":"BMC Med Inform Decis Mak."},{"key":"2020110612593113800_ocu033-B33","doi-asserted-by":"crossref","first-page":"655","DOI":"10.1377\/hlthaff.2010.0160","article-title":"Mixed results in the safety performance of computerized physician order entry","volume":"29","author":"Metzger","year":"2010","journal-title":"Health Aff."},{"key":"2020110612593113800_ocu033-B34","article-title":"Sentinel Event Alert: Safety Implementing Health Information and Converging Technologies","author":"Joint Commission"},{"key":"2020110612593113800_ocu033-B35","doi-asserted-by":"crossref","first-page":"290","DOI":"10.1542\/peds.2006-0367","article-title":"Computerized provider order entry implementation: no association with increased mortality rates in an intensive care unit","volume":"118","author":"Del Beccaro","year":"2006","journal-title":"Pediatrics."},{"key":"2020110612593113800_ocu033-B36","doi-asserted-by":"crossref","first-page":"797","DOI":"10.1542\/peds.2005-3132","article-title":"Lessons from \u201cUnexpected increased mortality after implementation of a commercially sold computerized physician order entry system\u201d","volume":"118","author":"Sittig","year":"2006","journal-title":"Pediatrics"},{"key":"2020110612593113800_ocu033-B37","first-page":"S43","article-title":"\u201cSmallball\u201d evaluation: a prescription for studying community-based information interventions","volume":"93","author":"Friedman","year":"2005","journal-title":"J Med Libr Assoc."},{"key":"2020110612593113800_ocu033-B38","doi-asserted-by":"crossref","first-page":"740","DOI":"10.1136\/bmj.330.7494.740","article-title":"What makes a good clinical decision support system?","volume":"330","author":"Purcell","year":"2005","journal-title":"Br Med J."},{"key":"2020110612593113800_ocu033-B39","doi-asserted-by":"crossref","first-page":"765","DOI":"10.1136\/bmj.38398.500764.8F","article-title":"Improving clinical practice using clinical decision support systems: a systematic review of trials to identify features critical to success","volume":"330","author":"Kawamoto","year":"2005","journal-title":"Br Med J."},{"key":"2020110612593113800_ocu033-B40","doi-asserted-by":"crossref","first-page":"135","DOI":"10.7326\/0003-4819-120-2-199401150-00007","article-title":"Effects of computer-based clinical decision support systems on clinician performance and patient outcome. A critical appraisal of research","volume":"120","author":"Johnston","year":"1994","journal-title":"Ann Intern Med."},{"key":"2020110612593113800_ocu033-B41","doi-asserted-by":"crossref","first-page":"1339","DOI":"10.1001\/jama.280.15.1339","article-title":"Effects of computer-based clinical decision support systems on physician performance and patient outcomes: a systematic review","volume":"280","author":"Hunt","year":"1998","journal-title":"J Am Med Assoc."},{"key":"2020110612593113800_ocu033-B42","doi-asserted-by":"crossref","first-page":"383","DOI":"10.1007\/s11606-007-0454-3","article-title":"Electronic medical record-assisted design of a cluster-randomized trial to improve diabetes care and outcomes","volume":"23","author":"Love","year":"2008","journal-title":"J Gen Intern Med."},{"key":"2020110612593113800_ocu033-B43","doi-asserted-by":"crossref","first-page":"750","DOI":"10.2337\/diacare.26.3.750","article-title":"A controlled trial of web-based diabetes disease management: the MGH diabetes primary care improvement project","volume":"26","author":"Meigs","year":"2003","journal-title":"Diabetes Care."},{"key":"2020110612593113800_ocu033-B44","doi-asserted-by":"crossref","first-page":"969","DOI":"10.1056\/NEJMoa041533","article-title":"Electronic alerts to prevent venous thromboembolism among hospitalized patients","volume":"352","author":"Kucher","year":"2005","journal-title":"N Engl J Med."},{"key":"2020110612593113800_ocu033-B45","doi-asserted-by":"crossref","DOI":"10.1155\/2012\/367345","article-title":"Analysis of a multilevel diagnosis decision support system and its implications: a case study","author":"Rodriguez-Gonzalez","year":"2012","journal-title":"Comput Math Methods Med."},{"key":"2020110612593113800_ocu033-B46","doi-asserted-by":"crossref","first-page":"2388","DOI":"10.1001\/archinte.165.20.2388","article-title":"A randomized outpatient trial of a decision-support information technology tool","volume":"165","author":"Apkon","year":"2005","journal-title":"Arch Intern Med."},{"key":"2020110612593113800_ocu033-B47","doi-asserted-by":"crossref","first-page":"563","DOI":"10.1197\/jamia.M1338","article-title":"Measuring the impact of diagnostic decision support on the quality of clinical decision making: development of a reliable and valid composite score","volume":"10","author":"Ramnarayan","year":"2003","journal-title":"J Am Med Inform Assoc."},{"key":"2020110612593113800_ocu033-B48","doi-asserted-by":"crossref","first-page":"22","DOI":"10.1186\/1472-6947-6-22","article-title":"Assessment of the potential impact of a reminder system on the reduction of diagnostic errors: a quasi-experimental study","volume":"6","author":"Ramnarayan","year":"2006","journal-title":"BMC Med Inform Decis Mak."},{"key":"2020110612593113800_ocu033-B49","doi-asserted-by":"crossref","first-page":"5","DOI":"10.1016\/j.artmed.2013.04.004","article-title":"From an expert-driven paper guideline to a user-centered decision support system: a usability comparison study","volume":"9","author":"Kilsdonk","year":"2013","journal-title":"Artif Intell Med."},{"key":"2020110612593113800_ocu033-B50","article-title":"Clinical decision support systems","author":"Trowbridge"},{"key":"2020110612593113800_ocu033-B51","doi-asserted-by":"crossref","first-page":"1223","DOI":"10.1001\/jama.293.10.1223","article-title":"Effects of computerized clinical decision support systems on practitioner performance and patient outcomes: a systematic review","volume":"293","author":"Garg","year":"2005","journal-title":"J Am Med Assoc."},{"key":"2020110612593113800_ocu033-B52","doi-asserted-by":"crossref","first-page":"1851","DOI":"10.1001\/jama.282.19.1851","article-title":"Enhancement of clinicians\u2019 diagnostic reasoning by computer-based consultation: a multisite study of 2 systems","volume":"282","author":"Friedman","year":"1999","journal-title":"J Am Med Assoc."},{"key":"2020110612593113800_ocu033-B53","doi-asserted-by":"crossref","first-page":"15","DOI":"10.1016\/S1386-5056(01)00183-6","article-title":"Evaluating informatics applications\u2014clinical decision support systems literature review","volume":"64","author":"Kaplan","year":"2001","journal-title":"Int J Med Inform."},{"key":"2020110612593113800_ocu033-B54","doi-asserted-by":"crossref","first-page":"290","DOI":"10.1197\/jamia.M2583","article-title":"Crossing the implementation chasm: a proposal for bold action","volume":"15","author":"Lorenzi","year":"2008","journal-title":"J Am Med Inform Assoc."},{"key":"2020110612593113800_ocu033-B55","doi-asserted-by":"crossref","first-page":"2366","DOI":"10.1001\/jama.292.19.2366","article-title":"Inpatient computer-based standing orders vs physician reminders to increase influenza and pneumococcal vaccination rates: a randomized trial","volume":"292","author":"Dexter","year":"2004","journal-title":"J Am Med Assoc."},{"key":"2020110612593113800_ocu033-B56"},{"key":"2020110612593113800_ocu033-B57","doi-asserted-by":"crossref","first-page":"45","DOI":"10.1136\/amiajnl-2011-000369","article-title":"Using FDA reports to inform a classification for health information technology safety problems","volume":"19","author":"Magrabi","year":"2012","journal-title":"J Am Med Inform Assoc."},{"key":"2020110612593113800_ocu033-B58","first-page":"853","article-title":"Patient harm associated with healthcare information technology: an analysis of events reported to the US Food and Drug Administration","volume":"2011","author":"Magrabi","year":"2011","journal-title":"AMIA Annu Symp Proc."},{"key":"2020110612593113800_ocu033-B59","doi-asserted-by":"crossref","first-page":"e1","DOI":"10.1136\/qshc.2002.004101","article-title":"Crisis management during anaesthesia: the development of an anaesthetic crisis management manual","volume":"14","author":"Runciman","year":"2005","journal-title":"Qual Saf Health Care."},{"key":"2020110612593113800_ocu033-B60","first-page":"1","article-title":"Why \u201cWhat data are necessary for this project?\u201d and other basic quesitons are important to address in public health informatics practice and research","volume":"3","author":"Dixon","year":"2011","journal-title":"J Public Health Inform."},{"key":"2020110612593113800_ocu033-B61","doi-asserted-by":"crossref","first-page":"501","DOI":"10.1177\/0310057X9302100502","article-title":"Symposium\u2014The Australian incident monitoring study","volume":"21","author":"Holland","year":"1993","journal-title":"Anaesth Intensive Care."},{"key":"2020110612593113800_ocu033-B62","volume-title":"ARRA OS Recovery Act Limited Competition: Impact of Decision-Support Systems on the Dissemination and Adoption of Imaging-Related Comparative Effectiveness Findings (UC4)","author":"Office of Extramural Research","year":"2010"},{"key":"2020110612593113800_ocu033-B63"},{"key":"2020110612593113800_ocu033-B64","doi-asserted-by":"crossref","first-page":"1276","DOI":"10.1001\/jama.2009.398","article-title":"Health care information technology vendors\u2019 \u201chold harmless\u201d clause: implications for patients and clinicians","volume":"301","author":"Koppel","year":"2009","journal-title":"J Am Med Assoc."},{"key":"2020110612593113800_ocu033-B65","first-page":"615","article-title":"The role of information technology in reducing medical errors","volume":"36","author":"Belmont","year":"2003","journal-title":"J Health Law."},{"key":"2020110612593113800_ocu033-B66","first-page":"1","volume-title":"Health Information Technology Evaluation Toolkit","author":"Cusack","year":"2009"},{"key":"2020110612593113800_ocu033-B67","doi-asserted-by":"crossref","first-page":"S21","DOI":"10.1016\/j.jbi.2007.08.006","article-title":"Playing smallball: approaches to evaluating pilot health exchange systems","volume":"40","author":"Johnson","year":"2007","journal-title":"J Biomed Inform."}],"container-title":["Journal of the American Medical Informatics Association"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/academic.oup.com\/jamia\/article-pdf\/22\/e1\/e13\/34146530\/ocu033.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"http:\/\/academic.oup.com\/jamia\/article-pdf\/22\/e1\/e13\/34146530\/ocu033.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2020,11,6]],"date-time":"2020-11-06T18:37:56Z","timestamp":1604687876000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/jamia\/article\/22\/e1\/e13\/702712"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2015,2,9]]},"references-count":67,"journal-issue":{"issue":"e1","published-online":{"date-parts":[[2015,2,9]]},"published-print":{"date-parts":[[2015,4,1]]}},"URL":"https:\/\/doi.org\/10.1093\/jamia\/ocu033","relation":{},"ISSN":["1527-974X","1067-5027"],"issn-type":[{"value":"1527-974X","type":"electronic"},{"value":"1067-5027","type":"print"}],"subject":[],"published-other":{"date-parts":[[2015,4]]},"published":{"date-parts":[[2015,2,9]]}}}