Evidence map›Paper›PMID 33368060›Full record

ArticleApplied clinical informatics2020

Clinical Decision Support System with Renal Dose Adjustment Did Not Improve Subsequent Renal and Hepatic Function among Inpatients: The Japan Adverse Drug Event Study.

Ryuhei Wada, Jiro Takeuchi, Tsukasa Nakamura, Tomohiro Sonoyama, Shinji Kosaka, Chisa Matsumoto, Mio Sakuma, Yoshinori Ohta, Takeshi Morimoto

Open access · hybridAbstract read
In one paragraph

Article in Applied clinical informatics, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
0.5field-weighted citation impact, top 36% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 7 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors at 3 institutions in 1 country.

Ryuhei WadaDepartment of Clinical Epidemiology, Hyogo College of Medicine, Nishinomiya, Hyogo, Japan.
Jiro TakeuchiDepartment of Clinical Epidemiology, Hyogo College of Medicine, Nishinomiya, Hyogo, Japan.
Tsukasa NakamuraDepartment of Infectious Diseases, Shimane Prefectural Central Hospital, Izumo, Shimane, Japan.
Tomohiro SonoyamaDepartment of Pharmacy, Shimane Prefectural Central Hospital, Izumo, Shimane, Japan.
Shinji KosakaShimane Prefectural Central Hospital, Izumo, Shimane, Japan.
Chisa MatsumotoCenter for Health Surveillance & Preventive Medicine, Tokyo Medical University, Tokyo, Japan.
Mio SakumaDepartment of Clinical Epidemiology, Hyogo College of Medicine, Nishinomiya, Hyogo, Japan.
Yoshinori OhtaEducation and Training Center for Students and Professionals in Healthcare, Hyogo College of Medicine, Nishinomiya, Hyogo, Japan.
Takeshi MorimotoDepartment of Clinical Epidemiology, Hyogo College of Medicine, Nishinomiya, Hyogo, Japan.ORCID 0000-0002-6844-739X
Hyogo Medical University · JPShimane Prefectural Central Hospital · JPTokyo Medical University · JP

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundMedication dose adjustment is crucial for patients with renal dysfunction (RD). The assessment of renal function is generally mandatory; however, the renal function may change during the hospital stay and the manual assessment is sometimes challenging.

objectiveWe developed the clinical decision support system (CDSS) that provided a recommended dose based on automated calculated renal function.

methodsWe conducted a prospective cohort study in a single teaching hospital in Japan. All hospitalized patients were included except for obstetrics/gynecology and pediatric wards between September 2013 and February 2015. The CDSS was implemented on December 2013. Renal and hepatic dysfunction (HD) were defined as changes in the estimated glomerular filtration rate (eGFR) and alanine aminotransferase or alkaline phosphatase levels based on these measurements during hospital stay. These measurements were obtained before (phase I), after (phase II), and 1 year after (phase III) the CDSS implementation.

resultsWe included 6,767 patients (phase I: 2,205; phase II: 2,279; phase III: 2,283). The patients' characteristics were similar among phases. Changes in eGFR were similar among phases, but the incidence of RD increased in phase III (phase I: 228 [10.3%]; phase II: 260 [11.4%]; phase III: 296 [13.0%],

conclusionThe CDSS implementation did not affect the incidence of renal and HD and changes in renal and hepatic function among hospitalized patients. The effectiveness of the CDSS with renal-guided doses should be investigated with respect to other endpoints.

Indexed as

Decision Support Systems, ClinicalDrug-Related Side Effects and Adverse ReactionsChildHumansInpatientsJapanKidneyProspective Studies

Identifiers

PMID33368060
PMCPMC7758157
OpenAlexW3114616619

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Registered trials

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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.