ArticleBMC medical informatics and decision making2015
A clinical decision support tool to screen health records for contraindications to stroke thrombolysis-a pilot study.
Article in BMC medical informatics and decision making, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
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Who cites it
3 citing papers in PubMed.
- Evaluating the Wasfaty E-Prescribing Platform Against Best Practices for Computerized Provider Order Entry.Healthcare (Basel, Switzerland) · 2025Article
- Automated Identification of Stroke Thrombolysis Contraindications from Synthetic Clinical Notes: A Proof-of-Concept Study.Cerebrovascular diseases extra · 2025Article
- Acute stroke CDS: automatic retrieval of thrombolysis contraindications from unstructured clinical letters.Frontiers in digital health · 2023Article
Corrections and comments
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Authors and funding
2 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe use of intravenous thrombolysis for stroke is limited by contraindications that may be difficult to identify promptly and accurately. Evidence supports the use of information technology-based clinical decision support (CDS) tools to achieve improvements in care delivery. The objective of this pilot study was to investigate the efficacy of a CDS tool to screen health records for contraindications to intravenous stroke thrombolysis.
methodsA CDS tool was developed to rapidly screen health information in seven affiliated hospitals for contraindications to stroke thrombolysis. A fixed-sequence, 2-period crossover study was conducted to test the efficacy of the CDS tool. Four mock patient records derived from the stroke registry that contained a total of nine contraindication items in two or more of the hospitals were used for testing purposes. The test patients were preset and balanced between groups with and without the CDS tool appearing six times in each group before recruiting the participating physicians. Physicians who were responsible for thrombolytic therapy and willing to sign informed consent were recruited. The participating physicians were asked to check a list of contraindications for two of the patients by using a shared electronic medical record system among the seven hospitals with and without the CDS tool. The test time and missed contraindications were recorded and analyzed statistically.
resultsA total of 14 physicians who were responsible for stroke thrombolysis were approached, and 12 signed informed consent and took the test. By using the CDS tool, the test time was reduced significantly from 14.6 ± 7.4 to 7.3 ± 5.2 min (P = 0.010). In a total of 54 contraindications, the number of missed contraindications was reduced significantly from 23 (42.6 %) to seven (13.0 %) (P = 0.001). The difference of missed contraindication number between the two groups was statistically significant either per physician or per contraindication item.
conclusionsBy screening health records for relevant contraindications, the use of a CDS tool may reduce the time needed to review medical records and reduce the number of missed contraindications for stroke thrombolysis.
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