Evidence map›Paper›PMID 36040207›Full record

ArticleJournal of the American Medical Informatics Association : JAMIA2022

Clinical decision support malfunctions related to medication routes: a case series.

Adam Wright, Scott Nelson, David Rubins, Richard Schreiber, Dean F Sittig

Abstract read
In one paragraph

Article in Journal of the American Medical Informatics Association : JAMIA, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
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

0 citing papers in PubMed.

No citing paper in PubMed yet.

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

5 authors.

Adam WrightDepartment of Biomedical Informatics, Vanderbilt University Medical Center, Nashville, Tennessee, USA.
Scott NelsonDepartment of Biomedical Informatics, Vanderbilt University Medical Center, Nashville, Tennessee, USA.ORCID 0000-0002-1941-1817
David RubinsDivision of General Internal Medicine and Primary Care, Brigham and Women's Hospital, Boston, Massachusetts, USA.
Richard SchreiberPenn State Health Holy Spirit Hospital Medical Center, Camp Hill, Pennsylvania, USA.ORCID 0000-0002-6138-7048
Dean F SittigSchool of Biomedical Informatics, University of Texas Health Science Center at Houston, Houston, Texas, USA.ORCID 0000-0001-5811-8915

Funding

Improving clinical decision support reliability using anomaly detection methodsR01LM011966 · NLM · VANDERBILT UNIVERSITY MEDICAL CENTER · PI WRIGHT, ADAM T · 2014 to 2017
$2.4M
Strategies for Engineering Reliable Value Sets (SERVS)R01LM013995 · NLM · VANDERBILT UNIVERSITY MEDICAL CENTER · PI ADAM T WRIGHT · 2022 to 2026
$1.0M
NLM NIH HHS R01 LM011966NLM NIH HHS R01 LM013995
6 · The paper itself

Abstract

objectiveTo identify common medication route-related causes of clinical decision support (CDS) malfunctions and best practices for avoiding them. MATERIALS AND

methodsCase series of medication route-related CDS malfunctions from diverse healthcare provider organizations.

resultsNine cases were identified and described, including both false-positive and false-negative alert scenarios. A common cause was the inclusion of nonsystemically available medication routes in value sets (eg, eye drops, ear drops, or topical preparations) when only systemically available routes were appropriate. DISCUSSION: These value set errors are common, occur across healthcare provider organizations and electronic health record (EHR) systems, affect many different types of medications, and can impact the accuracy of CDS interventions. New knowledge management tools and processes for auditing existing value sets and supporting the creation of new value sets can mitigate many of these issues. Furthermore, value set issues can adversely affect other aspects of the EHR, such as quality reporting and population health management.

conclusionValue set issues related to medication routes are widespread and can lead to CDS malfunctions. Organizations should make appropriate investments in knowledge management tools and strategies, such as those outlined in our recommendations.

Indexed as

Decision Support Systems, ClinicalMedical Order Entry SystemsElectronic Health RecordsOphthalmic SolutionsResearchSoftwareOphthalmic Solutionsalertsclinical decision supportelectronic health recordsmedication routesvalue sets

Identifiers

PMID36040207
PMCPMC9552204

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

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.