ArticleJournal of the American Medical Informatics Association : JAMIA2018
Unintended adverse consequences of a clinical decision support system: two cases.
Article in Journal of the American Medical Informatics Association : JAMIA, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 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
19 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Covid-19 hotlines, helplines and call centers: a systematic review of characteristics, challenges and lessons learned.BMC public health · 2024Pooled it
- Design, effectiveness, and economic outcomes of contemporary chronic disease clinical decision support systems: a systematic review and meta-analysis.Journal of the American Medical Informatics Association : JAMIA · 2022Pooled it
- Combining International Standards to Develop Clinical Decision Support for Parent Smoking Cessation in Pediatrics.Journal of medical Internet research · 2025Article
- Verification, validation, and uncertainty quantification of finite element analysis results for pedicle screw assemblies under ASTM F1717 flexion and extension testing.Frontiers in bioengineering and biotechnology · 2025Article
- Using shared clinical decision support to reduce adverse drug events and improve patient safety.Frontiers in digital health · 2025Review
- Applying the Non-Adoption, Abandonment, Scale-up, Spread, and Sustainability Framework Across Implementation Stages to Identify Key Strategies to Facilitate Clinical Decision Support System Integration Within a Large Metropolitan Health Service: Interview and Focus Group Study.JMIR medical informatics · 2024Article
- A scoping review of rule-based clinical decision support malfunctions.Journal of the American Medical Informatics Association : JAMIA · 2024Article
- Clinical Decision Support: Moving Beyond Interruptive "Pop-up" Alerts.Mayo Clinic proceedings · 2023Article
- Identifying barriers and facilitators to successful implementation of computerized clinical decision support systems in hospitals: a NASSS framework-informed scoping review.Implementation science : IS · 2023Article
- Real-Time User Feedback to Support Clinical Decision Support System Improvement.Applied clinical informatics · 2022Article
- User-centred design for machine learning in health care: a case study from care management.BMJ health & care informatics · 2022Article
- Leveraging law and ethics to promote safe and reliable AI/ML in healthcare.Frontiers in nuclear medicine · 2022Review
- Adopting newer strategies of perioperative quality improvement: The bandwagon moves on….Indian journal of anaesthesia · 2021Article
- Consequences of Rapid Telehealth Expansion in Nursing Homes: Promise and Pitfalls.Applied clinical informatics · 2021Article
- Algorithmic Detection of Boolean Logic Errors in Clinical Decision Support Statements.Applied clinical informatics · 2021Article
- What do senior physicians think about AI and clinical decision support systems: Quantitative and qualitative analysis of data from specialty societies.Clinical medicine (London, England) · 2020Article
- Potential New Approaches for Diagnosis of Alzheimer's Disease and Related Dementias.Frontiers in neurology · 2020Review
- Importance of clinical decision support system response time monitoring: a case report.Journal of the American Medical Informatics Association : JAMIA · 2019Article
- Smashing the strict hierarchy: three cases of clinical decision support malfunctions involving carvedilol.Journal of the American Medical Informatics Association : JAMIA · 2018Article
Corrections and comments
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Authors and funding
1 author.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Many institutions have implemented clinical decision support systems (CDSSs). While CDSS research papers have focused on benefits of these systems, there is a smaller body of literature showing that CDSSs may also produce unintended adverse consequences (UACs). Detailed here are 2 cases of UACs resulting from a CDSS. Both of these cases were related to external systems that fed data into the CDSS. In the first case, lack of knowledge of data categorization in an external pharmacy system produced a UAC; in the second case, the change of a clinical laboratory instrument produced the UAC. CDSSs rely on data from many external systems. These systems are dynamic and may have changes in hardware, software, vendors, or processes. Such changes can affect the accuracy of CDSSs. These cases point to the need for the CDSS team to be familiar with these external systems. This team (manager and alert builders) should include members in specific clinical specialties with deep knowledge of these external systems.
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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.