Evidence map›Paper›PMID 37805010›Full record

ArticleJournal of the American College of Radiology : JACR2023

Impact of Predictive Text Clinical Decision Support on Imaging Order Entry in the Emergency Department.

Govind S Mattay, Richard T Griffey, Vamsi Narra, Robert F Poirier, Andrew Bierhals

Abstract read
In one paragraph

Article in Journal of the American College of Radiology : JACR, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing 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

3 citing papers in PubMed.

  1. Review
  2. Article
  3. Review
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.

Govind S MattayMallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, Missouri. Electronic address: g.mattay@wustl.edu.
Richard T GriffeyAssociate Chief, Emergency Medicine, Department of Emergency Medicine, Washington University School of Medicine, St. Louis, Missouri.
Vamsi NarraSenior Vice Chair, Imaging Informatics and New Business Development, Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, Missouri; Chief, Radiology, Barnes-Jewish West County Hospital, St. Louis, Missouri; Associate Chief Medical Informatics Officer, BJC HealthCare, St. Louis, Missouri.
Robert F PoirierAssociate Chief, Emergency Medicine, Department of Emergency Medicine, Washington University School of Medicine, St. Louis, Missouri; Medical Director and Chief of Clinical Operations, Emergency Medicine, Barnes-Jewish Hospital, St. Louis, Missouri.
Andrew BierhalsVice Chair, Community Radiology, Vice Chair, Quality and Safety, Medical and Director for CT, Center for Clinical Imaging Research, Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, Missouri; Director of Cardiothoracic Imaging, Barnes-Jewish West County Hospital, St. Louis, Missouri. Electronic address: https://twitter.com/AMdmph.

Funding

AHRQ HHS R01 HS027811
6 · The paper itself

Abstract

purposeImaging clinical decision support (CDS) is designed to assist providers in selecting appropriate imaging studies and is now federally required. The aim of this study was to understand the effect of CDS on decisions and workflows in the emergency department (ED).

methodsThe authors' institution's order entry platform serves up structured indications for imaging orders. Imaging orders are scored by CDS on the basis of appropriate use criteria (AUC). CDS triggers alerts for imaging orders with low AUC scores. Because free text alone cannot be scored by CDS, an artificial intelligence predictive text (AIPT) module was implemented to guide the selection of structured indications when free-text indications are entered. A total of 17,355 imaging orders in the ED over 6 months were retrospectively analyzed.

resultsCDS alerts for low AUC scores were triggered for 3% of all imaging study orders (522 of 17,355). Providers spent an average of 24 seconds interacting with alerts. In 18 of 522 imaging orders with alerts, alternative studies were ordered. After AIPT implementation, the percentage of unscored studies significantly decreased from 81% to 45% (P < .001).

conclusionsIn a quaternary academic ED, CDS alerts triggered by low AUC scores caused minimal increase in time spent on imaging order entry but had a relatively marginal impact on imaging study selection. AIPT implementation increased the number of scored studies and could potentially enhance CDS effects. CDS implementation enables the collection of novel data regarding which imaging studies receive low AUC scores. Future work could include exploring alternative models of CDS implementation to maximize its impact.

Indexed as

Decision Support Systems, ClinicalMedical Order Entry SystemsArtificial IntelligenceEmergency Service, HospitalHumansRetrospective Studiesartificial intelligenceClinical decision supportdiagnostic imagingelectronic health recordshealth services overutilization

Identifiers

PMID37805010
PMCPMC12856965

What OpenQuestion holds

Textmetadata
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.