Evidence map›Paper›PMID 41410330›Full record

Observational studyBiomedica : revista del Instituto Nacional de Salud2025

Knowledge-based clinical decision support system for the automated classification of anemia in hemodialysis patients

Sebastián Tenorio, Luis Alfonso Valderrama, José Javier Arango-Álvarez, Luz Amparo Lozano, Iván Leonardo Mojica

Abstract readObservational StudyEnglish Abstract
In one paragraph

Observational study in Biomedica : revista del Instituto Nacional de Salud, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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1 · What the graph read from it

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2 · The registry

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3 · Its place in the literature

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4 · The record

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5 · Who and what money

Authors and funding

5 authors.

Sebastián TenorioSYNLAB Colombia, Bogotá, D. C., Colombia.ORCID 0009-0009-4249-1809
Luis Alfonso ValderramaClínica Imbanaco, Cali, Colombia.ORCID 0000-0003-1166-2694
José Javier Arango-ÁlvarezAsociación Colombiana de Medicina Interna - ACMI, Bogotá, D. C., Colombia.ORCID 0009-0001-0242-0557
Luz Amparo LozanoSYNLAB Colombia, Bogotá, D. C., Colombia.ORCID 0009-0005-4638-8703
Iván Leonardo MojicaSYNLAB Colombia, Bogotá, D. C., Colombia.ORCID 0009-0008-5941-1783

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Introduction: Anemia is a frequent complication in patients with chronic kidney disease undergoing hemodialysis and is associated with increased morbidity, mortality, and healthcare burden. Accurate classification is essential to optimize treatment with intravenous iron and erythropoiesis-stimulating agents. Rule-based clinical decision support systems (CDSS) provide a strategy to standardize this process. Objective: To describe the development and implementation of a knowledge-based clinical decision support system for the automated classification of anemia in hemodialysis patients using laboratory data. Materials and methods: This retrospective observational study included 883 adult patients receiving prevalent hemodialysis during 2023. An algorithm was developed based on established clinical guidelines [Sociedad Latinoamericana de Nefrología e Hipertensión (SLANH)], KDIGO, NICE to classify patients with hemoglobin below 12 g/dl into three categories: absolute iron deficiency, functional iron deficiency, and candidates for therapeutic trial with intravenous iron. The system also flagged cases with suspected severe secondary hyperparathyroidism (PTH > 800 pg/ml). Data was obtained from the laboratory information system and the clinical decision support system. We applied a descriptive statistical analysis. Results: The clinical decision support system automatically classified patients into the following categories: functional iron deficiency (39.2%), severe hyperparathyroidism (26.7%), absolute iron deficiency (17.7%), and candidates for intravenous iron trial (16.4%). A subgroup (9.5% within the functional iron deficiency group) also showed elevated PTH levels, suggesting potential resistance to erythropoiesis-stimulating agents. Distinct clinical profiles were observed across the groups. Conclusions: The clinical decision support system enabled automated and standardized classification of anemia in hemodialysis patients, supporting evidence-based clinical decision-making. Its implementation represents a digital health innovation with the potential to improve the quality and safety of anemia management in chronic kidney disease.

Indexed as

AnemiaDecision Support Systems, ClinicalKnowledge BasesRenal DialysisAdultAgedAlgorithmsFemaleHematinicsHemoglobinsHumansHyperparathyroidism, SecondaryMaleMiddle AgedRenal Insufficiency, ChronicRetrospective StudiesHematinicsHemoglobinsAnemiachronicclinicaldecision support systemsexpert systemsferritinsparathyroid hormonerenal dialysisrenal insufficiency

Identifiers

PMID41410330
PMCPMC12970531

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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.