{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,31]],"date-time":"2026-03-31T05:44:51Z","timestamp":1774935891356,"version":"3.50.1"},"reference-count":41,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2025,3,19]],"date-time":"2025-03-19T00:00:00Z","timestamp":1742342400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"},{"start":{"date-parts":[[2025,3,19]],"date-time":"2025-03-19T00:00:00Z","timestamp":1742342400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Med Inform Decis Mak"],"DOI":"10.1186\/s12911-025-02963-3","type":"journal-article","created":{"date-parts":[[2025,3,19]],"date-time":"2025-03-19T11:46:01Z","timestamp":1742384761000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Evaluation and validation of a clinical decision support system for dose optimisation in hospitalized patients with (morbid) obesity \u2013 a retrospective, observational study"],"prefix":"10.1186","volume":"25","author":[{"ORCID":"https:\/\/orcid.org\/0009-0009-9829-5647","authenticated-orcid":false,"given":"Lianne","family":"Brand","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4133-2370","authenticated-orcid":false,"given":"L.","family":"Mitrov-Winkelmolen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2834-5727","authenticated-orcid":false,"given":"T. M.","family":"Kuijper","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9337-7784","authenticated-orcid":false,"given":"T. M.","family":"Bosch","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3842-9585","authenticated-orcid":false,"given":"L. L.","family":"Krens","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2025,3,19]]},"reference":[{"key":"2963_CR1","unstructured":"World Obesity Day. 2022 \u2013 Accelerating action to stop obesity. [cited 2023 Nov 16]. Available from: https:\/\/www.who.int\/news\/item\/04-03-2022-world-obesity-day-2022-accelerating-action-to-stop-obesity"},{"key":"2963_CR2","unstructured":"Scientific American. World\u2019s Obese Population Hits 641 Million - Scientific American. 2016 [cited 2022 Feb 9]. Available from: https:\/\/www.scientificamerican.com\/article\/world-s-obese-population-hits-641-million\/"},{"key":"2963_CR3","unstructured":"Cleveland Clinic, Class III. Obesity (Morbid Obesity): Causes, Symptoms, Risks & Treatment. 2021 [cited 2022 Feb 9]. Available from: https:\/\/my.clevelandclinic.org\/health\/diseases\/21989-class-iii-obesity-formerly-known-as-morbid-obesity"},{"key":"2963_CR4","doi-asserted-by":"crossref","unstructured":"Hanley MJ, Abernethy DR, Greenblatt DJ. Effect of obesity on the pharmacokinetics of drugs in humans. Clin Pharmacokinet. 2010;49:71\u201387 [cited 2021 Jun 17]. Available from: https:\/\/pubmed.ncbi.nlm.nih.gov\/20067334\/","DOI":"10.2165\/11318100-000000000-00000"},{"key":"2963_CR5","doi-asserted-by":"crossref","unstructured":"Shashaty MGS, Stapleton RD. Physiological and management implications of obesity in critical illness. Ann Am Thorac Soc. 2014 Oct 1 [cited 2021 Jun 10];11(8):1286\u201397. Available from: \/pmc\/articles\/PMC4298999\/.","DOI":"10.1513\/AnnalsATS.201404-159FR"},{"key":"2963_CR6","unstructured":"Warmerdam EC, Krens L. Hoe doseer je geneesmiddelen bij obese pati\u00ebnten?| NPFO. Nederlands Platform voor Farmaceutisch Onderzoek. 2019 [cited 2021 Jun 10];4(4):a1705. Available from: https:\/\/www.npfo.nl\/artikel\/hoe-doseer-je-geneesmiddelen-bij-obese-patienten"},{"key":"2963_CR7","unstructured":"CDC, About Adult BMI.| Healthy Weight, Nutrition, and Physical Activity| CDC. 2021 [cited 2022 Feb 9]. Available from: https:\/\/www.cdc.gov\/healthyweight\/assessing\/bmi\/adult_bmi\/index.html"},{"key":"2963_CR8","doi-asserted-by":"crossref","unstructured":"Sankaralingam S, Kim RB, Padwal RS. The impact of obesity on the pharmacology of medications used for cardiovascular risk factor control. Can J Cardiol. 2015 Feb 1 [cited 2022 Feb 9];31(2):167\u201376. Available from: https:\/\/pubmed.ncbi.nlm.nih.gov\/25661551\/","DOI":"10.1016\/j.cjca.2014.10.025"},{"key":"2963_CR9","unstructured":"NVZA. Farmaceutische Pati\u00ebntenzorg en Medicatieveiligheid. [cited 2021 Jan 20]. Available from: https:\/\/nvza.nl\/voor-professionals\/farmaceutische-patientenzorg-en-medicatieveiligheid\/"},{"key":"2963_CR10","unstructured":"Chipsoft. Ge\u00efntegreerde NVZA-rules verhogen veiligheid. [cited 2022 Feb 9]. Available from: https:\/\/www.chipsoft.be\/nieuws\/81\/Geintegreerde-NVZA-rules-verhogen-veiligheid"},{"key":"2963_CR11","unstructured":"KNMP. Vragen en antwoorden over medicatieoverdracht \u2014 KNMP.nl. [cited 2022 Feb 9]. Available from: https:\/\/www.knmp.nl\/patientenzorg\/medicatieoverdracht\/vragen-en-antwoorden-over-medicatieoverdracht"},{"key":"2963_CR12","unstructured":"KNMP. Landelijke set MFB\u2019s \u2014 KNMP.nl. [cited 2022 Feb 9]. Available from: https:\/\/www.knmp.nl\/patientenzorg\/medicatiebewaking\/medisch-farmaceutische-beslisregels\/landelijke-set-mfbs"},{"key":"2963_CR13","unstructured":"Health Base. Health Base - Adviezen CI Morbide obesitas beschikbaar. [cited 2022 Feb 9]. Available from: https:\/\/www.healthbase.nl\/nieuws-en-updates\/2019\/12\/adviezen-ci-morbide-obesitas-beschikbaar\/?filter"},{"key":"2963_CR14","unstructured":"Verheijen E, Grandia L, Implementatierichtlijn MFB. Groeperen. 2021 Feb 5 [cited 2022 Feb 9]; Available from: www.z-index.nl."},{"key":"2963_CR15","unstructured":"KNMP Kennisbank. Contra-indicaties en voorzorgen| KNMP Kennisbank. [cited 2022 Feb 9]. Available from: https:\/\/kennisbank.knmp.nl\/article\/contra-indicaties_aandoeningen\/intro.html"},{"key":"2963_CR16","doi-asserted-by":"crossref","unstructured":"Lee NJ, Bakken S. Development of a prototype personal digital assistant-decision support system for the management of adult obesity. Int J Med Inform. 2007 Oct [cited 2021 Jun 10];76(SUPPL. 2). Available from: https:\/\/pubmed.ncbi.nlm.nih.gov\/17606400\/","DOI":"10.1016\/j.ijmedinf.2007.05.009"},{"key":"2963_CR17","doi-asserted-by":"crossref","unstructured":"Shaikh U, Berrong J, Nettiksimmons J, Byrd RS. Impact of Electronic Health Record Clinical Decision Support on the Management of Pediatric Obesity. American Journal of Medical Quality. 2015 Jan 21 [cited 2021 Jun 10];30(1):72\u201380. Available from: https:\/\/pubmed.ncbi.nlm.nih.gov\/24418755\/","DOI":"10.1177\/1062860613517926"},{"key":"2963_CR18","doi-asserted-by":"crossref","unstructured":"Vesely JM, Pronk NP, Kottke TE, Marshall PS. Obesity Treatment at HealthPartners: Adaptation of Clinical Guidelines into Systems for Practice Operations. Curr Obes Rep. 2016;5:312\u20139 [cited 2021 Jun 10]. Available from: https:\/\/pubmed.ncbi.nlm.nih.gov\/27342444\/","DOI":"10.1007\/s13679-016-0220-0"},{"key":"2963_CR19","unstructured":"Lee NJ, John R, Bakken S. Functional requirements specification and data modeling for a PDA-based decision support system for the screening and management of obesity. AMIA. Annual Symposium proceedings \/ AMIA Symposium AMIA Symposium. 2006 [cited 2021 Jun 10];2006:1002. Available from: \/pmc\/articles\/PMC1839530\/."},{"key":"2963_CR20","doi-asserted-by":"crossref","unstructured":"Akhloufi H, Hulscher M, Van Der Hoeven CP, Prins JM, Van Der Sijs H, Melles DC et al. A clinical decision support system algorithm for intravenous to oral antibiotic switch therapy: Validity, clinical relevance and usefulness in a three-step evaluation study. Journal of Antimicrobial Chemotherapy. 2018 Aug 1 [cited 2021 Jun 10];73(8):2201\u20136. Available from: https:\/\/pubmed.ncbi.nlm.nih.gov\/29718336\/","DOI":"10.1093\/jac\/dky141"},{"key":"2963_CR21","doi-asserted-by":"crossref","unstructured":"Boussadi A, Caruba T, Karras A, Berdot S, Degoulet P, Durieux P et al. Validity of a clinical decision rule-based alert system for drug dose adjustment in patients with renal failure intended to improve pharmacists\u2019 analysis of medication orders in hospitals. Int J Med Inform. 2013 Oct [cited 2021 Jun 10];82(10):964\u201372. Available from: https:\/\/pubmed.ncbi.nlm.nih.gov\/23831104\/","DOI":"10.1016\/j.ijmedinf.2013.06.006"},{"key":"2963_CR22","doi-asserted-by":"publisher","unstructured":"Quintens C, De Rijdt T, Van Nieuwenhuyse T, Simoens S, Peetermans WE, Van Den Bosch B et al. Development and implementation of check of Medication Appropriateness (CMA): Advanced pharmacotherapy-related clinical rules to support medication surveillance. BMC Med Inform Decis Mak. 2019 Feb 11 [cited 2021 Jun 10];19(1):1\u201310. Available from: https:\/\/doi.org\/10.1186\/s12911-019-0748-5","DOI":"10.1186\/s12911-019-0748-5"},{"key":"2963_CR23","doi-asserted-by":"crossref","unstructured":"Saverno KR, Hines LE, Warholak TL, Grizzle AJ, Babits L, Clark C et al. Ability of pharmacy clinical decision-support software to alert users about clinically important drug-drug interactions. Journal of the American Medical Informatics Association [Internet]. 2011 Jan [cited 2021 Jun 10];18(1):32\u20137. Available from: https:\/\/pubmed.ncbi.nlm.nih.gov\/21131607\/","DOI":"10.1136\/jamia.2010.007609"},{"key":"2963_CR24","doi-asserted-by":"crossref","unstructured":"Segal G, Segev A, Brom A, Lifshitz Y, Wasserstrum Y, Zimlichman E. Reducing drug prescription errors and adverse drug events by application of a probabilistic, machine-learning based clinical decision support system in an inpatient setting. Journal of the American Medical Informatics Association. 2019 Nov 15 [cited 2021 Jun 10];26(12):1560\u20135. Available from: https:\/\/pubmed.ncbi.nlm.nih.gov\/31390471\/","DOI":"10.1093\/jamia\/ocz135"},{"key":"2963_CR25","doi-asserted-by":"crossref","unstructured":"Warholak TL, Hines LE, Saverno KR, Grizzle AJ, Malone DC. Assessment tool for pharmacy drug-drug interaction software. Journal of the American Pharmacists Association. 2011 [cited 2021 Jun 10];51(3):418\u201324. Available from: https:\/\/pubmed.ncbi.nlm.nih.gov\/21555296\/","DOI":"10.1331\/JAPhA.2011.10054"},{"key":"2963_CR26","doi-asserted-by":"crossref","unstructured":"Abildgaard A, Madsen SA, Hvas AM. Dosage of Anticoagulants in Obesity: Recommendations Based on a Systematic Review. Semin Thromb Hemost. 2020 Nov 1 [cited 2023 Nov 16];46(8):932\u201369. Available from: https:\/\/pubmed.ncbi.nlm.nih.gov\/33368113\/","DOI":"10.1055\/s-0040-1718405"},{"key":"2963_CR27","doi-asserted-by":"crossref","unstructured":"Kido K, Lee JC, Hellwig T, Gulseth MP. Use of Direct Oral Anticoagulants in Morbidly Obese Patients. Pharmacotherapy. 2020 Jan 1 [cited 2023 Nov 6];40(1):72\u201383. Available from: https:\/\/pubmed.ncbi.nlm.nih.gov\/31834939\/","DOI":"10.1002\/phar.2353"},{"key":"2963_CR28","doi-asserted-by":"crossref","unstructured":"Piran S, Traquair H, Chan N, Bhagirath V, Schulman S. Peak plasma concentration of direct oral anticoagulants in obese patients weighing over 120 kilograms: A retrospective study. Res Pract Thromb Haemost. 2018 Oct 1 [cited 2023 Nov 6];2(4):684\u20138. Available from: https:\/\/pubmed.ncbi.nlm.nih.gov\/30349887\/","DOI":"10.1002\/rth2.12146"},{"key":"2963_CR29","doi-asserted-by":"crossref","unstructured":"de Vries F, Smit AAJ, Wolbink G, de Vries A, Loeff FC, Franssen EJF. Case report: Pharmacokinetics of pembrolizumab in a patient with stage IV non\u2013small cell lung cancer after a single 200\u00a0mg administration. Front Oncol. 2023;12.","DOI":"10.3389\/fonc.2022.960116"},{"issue":"7","key":"2963_CR30","doi-asserted-by":"publisher","first-page":"683","DOI":"10.1093\/ajhp\/60.7.683","volume":"60","author":"J Smith","year":"2003","unstructured":"Smith J, Canton EM. Weight-based administration of Dalteparin in obese patients. Am J Health-System Pharm. 2003;60(7):683\u20137.","journal-title":"Am J Health-System Pharm"},{"key":"2963_CR31","doi-asserted-by":"crossref","unstructured":"Rocca B, Fox KAA, Ajjan RA, Andreotti F, Baigent C, Collet JP et al. Antithrombotic therapy and body mass: an expert position paper of the ESC Working Group on Thrombosis. Eur Heart J. 2018 May 14 [cited 2023 Jun 19];39(19):1672\u201386. Available from: https:\/\/pubmed.ncbi.nlm.nih.gov\/29509886\/","DOI":"10.1093\/eurheartj\/ehy066"},{"key":"2963_CR32","doi-asserted-by":"crossref","unstructured":"Smit C, Wasmann RE, Goulooze SC, Wiezer MJ, van Dongen EPA, Mouton JW et al. Population pharmacokinetics of vancomycin in obesity: Finding the optimal dose for (morbidly) obese individuals. Br J Clin Pharmacol. 2020 Feb 1 [cited 2023 Nov 16];86(2):303\u201317. Available from: https:\/\/pubmed.ncbi.nlm.nih.gov\/31661553\/","DOI":"10.1111\/bcp.14144"},{"key":"2963_CR33","doi-asserted-by":"crossref","unstructured":"Durand C, Bylo M, Howard B, Belliveau P. Vancomycin Dosing in Obese Patients: Special Considerations and Novel Dosing Strategies. Ann Pharmacother. 2018 Jun 1 [cited 2023 Nov 16];52(6):580\u201390. Available from: https:\/\/pubmed.ncbi.nlm.nih.gov\/29262697\/","DOI":"10.1177\/1060028017750084"},{"key":"2963_CR34","doi-asserted-by":"crossref","unstructured":"Utrup TR, Mueller EW, Healy DP, Callcut RA, Peterson JD, Hurford WE. High-dose ciprofloxacin for serious gram-negative infection in an obese, critically ill patient receiving continuous venovenous hemodiafiltration. Ann Pharmacother. 2010 Oct [cited 2023 Nov 16];44(10):1660\u20134. Available from: https:\/\/pubmed.ncbi.nlm.nih.gov\/20736424\/","DOI":"10.1345\/aph.1P234"},{"key":"2963_CR35","doi-asserted-by":"crossref","unstructured":"Hollenstein UM, Brunner M, Schmid R, M\u00fcller M. Soft tissue concentrations of ciprofloxacin in obese and lean subjects following weight-adjusted dosing. Int J Obes Relat Metab Disord. 2001;25(3):354\u20138 [cited 2023 Nov 16]. Available from: https:\/\/pubmed.ncbi.nlm.nih.gov\/11319632\/","DOI":"10.1038\/sj.ijo.0801555"},{"key":"2963_CR36","unstructured":"Microsoft. Wat is Power Query?| Microsoft Docs. [cited 2022 Feb 9]. Available from: https:\/\/docs.microsoft.com\/nl-nl\/power-query\/power-query-what-is-power-query"},{"key":"2963_CR37","unstructured":"10.3 - Sensitivity. Specificity, Positive Predictive Value, and Negative Predictive Value| STAT 507. [cited 2022 Feb 9]. Available from: https:\/\/online.stat.psu.edu\/stat507\/lesson\/10\/10.3"},{"key":"#cr-split#-2963_CR38.1","doi-asserted-by":"crossref","unstructured":"Martinez JA, Belastegui A, Basabe I, Goicoechea X, Aguirre C, Lizeaga N et al. Derivation and validation of a clinical prediction rule for delirium in patients admitted to a medical ward: an observational study. BMJ Open. 2012;2","DOI":"10.1136\/bmjopen-2012-001599"},{"key":"#cr-split#-2963_CR38.2","unstructured":"(5) [cited 2022 Feb 9]. Available from: https:\/\/pubmed.ncbi.nlm.nih.gov\/22983876\/"},{"key":"2963_CR39","doi-asserted-by":"crossref","unstructured":"Rommers MK, Zwaveling J, Guchelaar HJ, Teepe-Twiss IM. Evaluation of rule effectiveness and positive predictive value of clinical rules in a Dutch clinical decision support system in daily hospital pharmacy practice. Artif Intell Med. 2013 Sep [cited 2021 Jun 30];59(1):15\u201321. Available from: https:\/\/pubmed.ncbi.nlm.nih.gov\/23664455\/","DOI":"10.1016\/j.artmed.2013.04.001"},{"key":"2963_CR40","doi-asserted-by":"crossref","unstructured":"Ancker JS, Edwards A, Nosal S, Hauser D, Mauer E, Kaushal R. Effects of workload, work complexity, and repeated alerts on alert fatigue in a clinical decision support system. BMC Med Inform Decis Mak. 2017 Apr 10 [cited 2022 Feb 9];17(1). Available from: \/pmc\/articles\/PMC5387195\/","DOI":"10.1186\/s12911-017-0430-8"}],"container-title":["BMC Medical Informatics and Decision Making"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12911-025-02963-3.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s12911-025-02963-3\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12911-025-02963-3.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,3,19]],"date-time":"2025-03-19T11:46:22Z","timestamp":1742384782000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmcmedinformdecismak.biomedcentral.com\/articles\/10.1186\/s12911-025-02963-3"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,3,19]]},"references-count":41,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2025,12]]}},"alternative-id":["2963"],"URL":"https:\/\/doi.org\/10.1186\/s12911-025-02963-3","relation":{},"ISSN":["1472-6947"],"issn-type":[{"value":"1472-6947","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,3,19]]},"assertion":[{"value":"5 December 2023","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"7 March 2025","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"19 March 2025","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The study was reviewed by the Medical Research Ethics Committees United (MEC-U) September 20th 2021 and was deemed as not subject to the WMO (Medical Research Involving Human Subjects Act). The research was thereafter accepted by the local ethics committee of the Maasstad Hospital. Informed consent was waved based on article 458 of the Dutch Medical Treatment Contracts Act (WGBO). Patients were excluded if they had a registered objection against participating in scientific research in the EHR.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"140"}}