ArticleJournal of the American Medical Informatics Association : JAMIA2016
Modeling information flows in clinical decision support: key insights for enhancing system effectiveness.
Article in Journal of the American Medical Informatics Association : JAMIA, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 24 papers, 2 of them syntheses that pooled it.
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
24 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Effectiveness of clinical decision support in fall prevention among older adults: A systematic review and meta-analysis.PloS one · 2026Pooled it
- Comprehensive process model of clinical information interaction in primary care: results of a "best-fit" framework synthesis.Journal of the American Medical Informatics Association : JAMIA · 2018Pooled it
- Pre-implementation adaptation of primary care cancer prevention clinical decision support in a predominantly rural healthcare system.BMC medical informatics and decision making · 2020Trial
- Barriers and facilitators to implementing cancer prevention clinical decision support in primary care: a qualitative study.BMC health services research · 2019Trial
- Trial
- Trial
- Intelligent Reasoning Cues: A Framework and Case Study of the Roles of AI Information in Complex Decisions.Proceedings of the SIGCHI conference on human factors in computing systems. CHI Conference · 2026Article
- Perinatal Identification, Referral, and Integrated Management for Improving Depression: Development, Feasibility and Pilot Randomised Controlled Trial of the PIRIMID System.Healthcare (Basel, Switzerland) · 2025Article
- Clinical decision support systems for maternity care: a systematic review and meta-analysis.EClinicalMedicine · 2024Article
- Effect of Digital Early Warning Scores on Hospital Vital Sign Observation Protocol Adherence: Stepped-Wedge Evaluation.Journal of medical Internet research · 2024Article
- Understanding the Digital Disruption of Health Care: An Ethnographic Study of Real-Time Multidisciplinary Clinical Behavior in a New Digital Hospital.Applied clinical informatics · 2022Article
- The development of a web-based app employing machine learning for delirium prevention in long-term care facilities in South Korea.BMC medical informatics and decision making · 2022Review
- Clinical validation of clinical decision support systems for medication review: A scoping review.British journal of clinical pharmacology · 2022Article
- Using guideline-based clinical decision support in oncological multidisciplinary team meetings: A prospective, multicenter concordance study.International journal for quality in health care : journal of the International Society for Quality in Health Care · 2022Observational
- Interpretable Clinical Decision Support System for Audiology Based on Predicted Common Audiological Functional Parameters (CAFPAs).Diagnostics (Basel, Switzerland) · 2022Article
- Expert validation of prediction models for a clinical decision-support system in audiology.Frontiers in neurology · 2022Article
- Physical and information workflow mapping of vancomycin therapeutic drug management: A single site case study revealing potential gaps in the process.Journal of medical systems · 2021Article
- Effect of Interventions With a Clinical Decision Support System for Hospitalized Older Patients: Systematic Review Mapping Implementation and Design Factors.JMIR medical informatics · 2021Review
- Social dynamics of a population-level dashboard for antimicrobial stewardship: A qualitative analysis.American journal of infection control · 2021Article
- Understanding primary care providers' perceptions of cancer prevention and screening in a predominantly rural healthcare system in the upper Midwest.BMC health services research · 2019Article
Corrections and comments
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Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
A fundamental challenge in the field of clinical decision support is to determine what characteristics of systems make them effective in supporting particular types of clinical decisions. However, we lack such a theory of decision support itself and a model to describe clinical decisions and the systems to support them. This article outlines such a framework. We present a two-stream model of information flow within clinical decision-support systems (CDSSs): reasoning about the patient (the clinical stream), and reasoning about the user (the cognitive-behavioral stream). We propose that CDSS "effectiveness" be measured not only in terms of a system's impact on clinical care, but also in terms of how (and by whom) the system is used, its effect on work processes, and whether it facilitates appropriate decisions by clinicians and patients. Future research into which factors improve the effectiveness of decision support should not regard CDSSs as a single entity, but should instead differentiate systems based on their attributes, users, and the decision being supported.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.