{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T19:15:38Z","timestamp":1791486938825,"version":"4.3.4"},"reference-count":41,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T00:00:00Z","timestamp":1791417600000},"content-version":"vor","delay-in-days":7,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T00:00:00Z","timestamp":1790812800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100004484","name":"Tehran University of Medical Sciences and Health Services","doi-asserted-by":"publisher","award":["70017"],"award-info":[{"award-number":["70017"]}],"id":[{"id":"10.13039\/501100004484","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Evaluation Clinical Practice"],"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Rationale<\/jats:title>\n                    <jats:p>Mobile health (mHealth) offers a modern educational approach for delivering behavioural interventions and enhancing healthcare professionals' knowledge, particularly through technology\u2010enhanced tools like clinical decision support systems (CDSS). Given the complexity of AF thromboprophylaxis\u2014balancing thromboembolic\/bleeding risk, comorbidities, considering lab data, and drug interactions such tools are critical, as evidence\u2010based thromboprophylaxis reduces both stroke risk and mortality.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Aims and Objectives<\/jats:title>\n                    <jats:p>This study aimed to examine changes in clinical pharmacy and cardiology residents' performance on case\u2010based multiple\u2010choice questions (MCQs) related to AF thromboprophylaxis and their self\u2010reported confidence in their responses following exposure to the ACAFiB CDSS.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Using a quasi\u2011experimental pre\u2011test\/post\u2011test design, the ACAFiB web\u2011based CDSS was assessed for its potential to assist in improving learning and confidence. Fifteen complex clinical scenarios in multiple\u2011choice format were used for the pre\u2011test, and another 15 thematically similar scenarios were used for the post\u2011test. Thirty\u2011one residents participated in two exams, 1 week apart. During the pre\u2011test, participants could search freely, whereas in the post\u2011test, they were restricted to using only ACAFiB. They also reported their confidence level for each response.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Test scores increased from 7.06\u2009\u00b1\u20092.08 to 10.74\u2009\u00b1\u20092.11 (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001; effect size: 1.71), and confidence\u2010weighted scores increased from 0.71\u2009\u00b1\u200910.05 to 17.90\u2009\u00b1\u200910.52 (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001; effect size: 1.43) following ACAFiB exposure. These findings indicate improved performance on the case\u2010based assessment and higher confidence\u2010weighted scores after use of the CDSS. No significant differences were observed between residents based on specialty, residency entry year, or gender.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>In conclusion, this study suggests that the use of the ACAFiB CDSS is associated with improvements in residents' clinical decision\u2010making performance and confidence in managing thromboprophylaxis for AF patients. Future studies should evaluate the tool's effectiveness using patient\u2011centred outcomes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/jep.70660","type":"journal-article","created":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T18:19:19Z","timestamp":1791483559000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["A Clinical Decision Support System for AF Thromboprophylaxis: Its Impact on Residents' Learning and Confidence in Clinical Decision\u2010Making"],"prefix":"10.1111","volume":"32","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4660-7057","authenticated-orcid":false,"given":"Ramin","family":"Ansari","sequence":"first","affiliation":[{"name":"Department of Clinical Pharmacy, School of Pharmacy Tehran University of Medical Sciences (TUMS) Tehran Iran"},{"name":"Research Center for Rational Use of Drugs Tehran University of Medical Sciences (TUMS) Tehran Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2131-0409","authenticated-orcid":false,"given":"Reza","family":"Mollazadeh","sequence":"additional","affiliation":[{"name":"Department of Cardiology, School of Medicine, Imam Khomeini Hospital Complex (IKHC) Tehran University of Medical Sciences (TUMS) Tehran Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9578-4172","authenticated-orcid":false,"given":"Mahboobeh Khabaz","family":"Mafinejad","sequence":"additional","affiliation":[{"name":"Department of Medical Education, Health Professions Education Research Center, Education Development Center, School of Medicine Tehran University of Medical Sciences Tehran Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1985-8720","authenticated-orcid":false,"given":"Ali Asghar","family":"Safaei","sequence":"additional","affiliation":[{"name":"Department of Medical Informatics, Faculty of Medical Sciences Tarbiat Modares University Tehran Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eisa","family":"Rezaei","sequence":"additional","affiliation":[{"name":"Department of Medical Education Virtual University of Medical Sciences Tehran Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Soha","family":"Namazi","sequence":"additional","affiliation":[{"name":"Department of Clinical Pharmacy, School of Pharmacy Tehran University of Medical Sciences (TUMS) Tehran Iran"},{"name":"Research Center for Rational Use of Drugs Tehran University of Medical Sciences (TUMS) Tehran Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7699-8538","authenticated-orcid":false,"given":"Keyhan","family":"Mohammadi","sequence":"additional","affiliation":[{"name":"Department of Clinical Pharmacy, School of Pharmacy Tehran University of Medical Sciences (TUMS) Tehran Iran"},{"name":"Research Center for Rational Use of Drugs Tehran University of Medical Sciences (TUMS) Tehran Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,10,8]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1177\/1474515118793051"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12909-015-0504-1"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2023.08.017"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehae176"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.3390\/healthcare9080999"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-146-12-200706190-00007"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1001\/archinte.164.18.2044"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2022.23099"},{"key":"e_1_2_11_10_1","first-page":"73","article-title":"Design and Evaluation of an Application for Recording of Pharmacy Students' Attendance via Smartphones and Personal Computer","volume":"3","author":"Aghakouchakzadeh M.","year":"2015","journal-title":"Journal of Pharmaceutical Care"},{"issue":"1","key":"e_1_2_11_11_1","first-page":"18","article-title":"Designing PharmQuiz Educational Game Application to Facilitate Learning of Pharmaceutical Information for Pharmacy Students","volume":"9","author":"Izadpanah M.","year":"2021","journal-title":"Journal of Pharmaceutical Care"},{"key":"e_1_2_11_12_1","first-page":"54","volume-title":"DSS 2.0\u2013Supporting Decision Making With New Technologies","author":"Delir Haghighi P.","year":"2014"},{"key":"e_1_2_11_13_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pmed.1001362"},{"key":"e_1_2_11_14_1","unstructured":"World Health Organization. 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