ArticleJMIR medical informatics2026
Safety and Performance Evaluation of a Clinical Decision Support System for Imatinib Therapeutic Drug Monitoring: In Silico Study.
Article in JMIR medical informatics, 2026. 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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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.
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Authors and funding
15 authors.
Funding
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Abstract
Background: Therapeutic drug monitoring (TDM) aims to optimize clinical outcomes but is hindered by logistical delays and susceptibility to data errors. Integrating model-informed precision dosing with point-of-care testing, fortified by rule-based validation and alerts, forms a transformative clinical decision support system (CDSS) essential for securing this complex workflow. Objective: This study evaluates, Methods: We simulated a set of 60 virtual patients using a previously developed population pharmacokinetic model and deliberately enriched it with data-quality errors (eg, timing inaccuracies and reporting errors) to stress-test system resilience. We compared CDSS and TDM expert performances based on their error-detection capabilities and the clinical impact on therapeutic target attainment and safety. Results: The CDSS and the expert demonstrated comparable error-detection capabilities. The CDSS showed numerically higher sensitivity (53%, 95% CI 35%-70% vs 45%, 95% CI 30%-61%) and lower specificity (83%, 95% CI 63%-95% vs 100%, 95% CI 81%-100%). Clinically, the CDSS demonstrated significantly higher rates of target attainment than the expert (33/60, 55% vs 22/60, 37%; Conclusions: The CDSS demonstrated high efficacy in optimizing imatinib exposure while serving as a robust digital gatekeeper. While active optimization drives higher efficacy, a few observed detrimental cases highlight that algorithmic safety remains contingent on data integrity. This proof-of-concept study validates the CDSS architecture as a prerequisite for future prospective clinical trials.
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