ArticleJournal of the American Medical Informatics Association : JAMIA
Comparison of a basic and an advanced pharmacotherapy-related clinical decision support system in a hospital care setting in the Netherlands.
Article in Journal of the American Medical Informatics Association : JAMIA. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 31 papers.
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Who cites it
31 citing papers in PubMed.
- Barriers and facilitators for intensive care nurses in using clinical decision support systems for intravenous Y-site compatibility in intensive care: A survey study.International journal of nursing studies advances · 2026Article
- The Impact of Customized Screening Intervals on the Burden of Drug-Drug Interaction Alerts: An Interrupted Time Series Analysis.Journal of medical systems · 2024Article
- The use of artificial intelligence to optimize medication alerts generated by clinical decision support systems: a scoping review.Journal of the American Medical Informatics Association : JAMIA · 2024Article
- Development and implementation of medication-related clinical rules for obstetrics, gynaecology, and paediatric outpatients.European journal of hospital pharmacy : science and practice · 2024Article
- Article
- Post-implementation optimization of medication alerts in hospital computerized provider order entry systems: a scoping review.Journal of the American Medical Informatics Association : JAMIA · 2023Article
- An Ontology-Based Approach to Improving Medication Appropriateness in Older Patients: Algorithm Development and Validation Study.JMIR medical informatics · 2023Article
- Combining text mining with clinical decision support in clinical practice: a scoping review.Journal of the American Medical Informatics Association : JAMIA · 2023Article
- OntoPharma: ontology based clinical decision support system to reduce medication prescribing errors.BMC medical informatics and decision making · 2022Article
- Decision Support Tools in Adult Long-term Care Facilities: Scoping Review.Journal of medical Internet research · 2022Article
- Contextualized Drug-Drug Interaction Management Improves Clinical Utility Compared With Basic Drug-Drug Interaction Management in Hospitalized Patients.Clinical pharmacology and therapeutics · 2022Article
- Clinical validation of clinical decision support systems for medication review: A scoping review.British journal of clinical pharmacology · 2022Article
- Alerts in Clinical Decision Support Systems (CDSS): A Bibliometric Review and Content Analysis.Healthcare (Basel, Switzerland) · 2022Article
- Management of drug-disease interactions: a best practice from the Netherlands.International journal of clinical pharmacy · 2021Article
- A Narrative Review of Clinical Decision Support for Inpatient Clinical Pharmacists.Applied clinical informatics · 2021Review
- The use of a clinical decision support tool to assess the risk of QT drug-drug interactions in community pharmacies.Therapeutic advances in drug safety · 2021Article
- Development, Implementation, and Evaluation of a Personalized Machine Learning Algorithm for Clinical Decision Support: Case Study With Shingles Vaccination.Journal of medical Internet research · 2020Article
- Reducing Inappropriate Drug Use in Older Patients by Use of Clinical Decision Support in Community Pharmacy: A Mixed-Methods Evaluation.Drugs & aging · 2020Article
- Development and implementation of "Check of Medication Appropriateness" (CMA): advanced pharmacotherapy-related clinical rules to support medication surveillance.BMC medical informatics and decision making · 2019Observational
- Considerations of prescribers and pharmacists for the use of non-selective β-blockers in asthma and COPD patients: An explorative study.Journal of evaluation in clinical practice · 2018Observational
Corrections and comments
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Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
unlabelledOBJECTIVE To compare the clinical relevance of medication alerts in a basic and in an advanced clinical decision support system (CDSS).
designA prospective observational study. MATERIALS AND
methodsWe collected 4023 medication orders in a hospital for independent evaluation in two pharmacotherapy-related decision support systems. Only the more advanced system considered patient characteristics and laboratory test results in its algorithms. Two pharmacists assessed the clinical relevance of the medication alerts produced. The alert was considered relevant if the pharmacist would undertake action (eg, contact the physician or the nurse). The primary analysis concerned the positive predictive value (PPV) for clinically relevant medication alerts in both systems.
resultsThe PPV was significantly higher in the advanced system (5.8% vs 17.0%; p<0.05). Significant differences were found in the alert categories: drug-(drug) interaction (9.9% vs 14.8%; p<0.05), drug-age interaction (2.9% vs 73.3%; p<0.05), and dosing guidance (5.6% vs 16.9%; p<0.05). Including laboratory values and other patient characteristics resulted in a significantly higher PPV for the advanced CDSS compared to the basic medication alerts (12.2% vs 23.3%; p<0.05).
conclusionThe advanced CDSS produced a higher proportion of clinically relevant medication alerts, but the number of irrelevant alerts remained high. To improve the PPV of the advanced CDSS, the algorithms should be optimized by identifying additional risk modifiers and more data should be made electronically available to improve the performance of the algorithms. Our study illustrates and corroborates the need for cyclic testing of technical improvements in information technology in circumstances representative of daily clinical practice.
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