Computer decision support systems for asthma. A systematic review
Computer decision support systems for asthma. A systematic review
BACKGROUND: Increasing use of electronic health records offers the potential to incorporate computer decision support systems (CDSSs) to prompt evidence-based actions within routine consultations.
AIM: To synthesise the evidence for the use of CDSSs by professionals managing people with asthma.
MATERIALS AND METHODS: We systematically searched Medline, Embase, Health Technology Assessment, Cochrane and Inspec databases (1990 to April 2012, no language restrictions) for trials, and four online repositories for unpublished studies. We also wrote to authors. Eligible studies were randomised controlled trials of CDSSs supporting professional management of asthma. Studies were appraised (Cochrane Risk of Bias Tool) and findings synthesised narratively.
RESULTS: A total of 5787 articles were screened, and eight trials were found eligible, with six at high risk of bias. Overall, CDSSs for professionals were ineffective. Usage of the systems was generally low: in the only trial at low risk of bias the CDSS was not used at all. When a CDSS was used, compliance with the advice offered was also low. However, if actually used, CDSSs could result in closer guideline adherence (improve investigating, prescribing and issuing of action plans) and could improve some clinical outcomes. The study at moderate risk of bias showed increased prescribing of inhaled steroids.
CONCLUSIONS: The current generation of CDSSs is unlikely to result in improvements in outcomes for patients with asthma because they are rarely used and the advice is not followed. Future decision support systems need to align better with professional workflows so that pertinent and timely advice is easily accessible within the consultation.
Asthma, Clinical Trials as Topic, Decision Support Systems, Clinical, Humans, Outcome and Process Assessment (Health Care), Quality of Life, Treatment Outcome, Journal Article, Research Support, Non-U.S. Gov't, Review
14005
Matui, Patricia
7ada45ed-82d0-426c-a006-0feddbdde64d
Wyatt, Jeremy C.
8361be5a-fca9-4acf-b3d2-7ce04126f468
Pinnock, Hilary
6d424703-d584-44a4-9114-d513ea01202e
Sheikh, Aziz
5b7eb24b-0820-4bd6-8304-cc46bbe561a8
McLean, Susannah
d79ea9ec-702c-4f42-8a91-17a55e798d55
20 May 2014
Matui, Patricia
7ada45ed-82d0-426c-a006-0feddbdde64d
Wyatt, Jeremy C.
8361be5a-fca9-4acf-b3d2-7ce04126f468
Pinnock, Hilary
6d424703-d584-44a4-9114-d513ea01202e
Sheikh, Aziz
5b7eb24b-0820-4bd6-8304-cc46bbe561a8
McLean, Susannah
d79ea9ec-702c-4f42-8a91-17a55e798d55
Matui, Patricia, Wyatt, Jeremy C., Pinnock, Hilary, Sheikh, Aziz and McLean, Susannah
(2014)
Computer decision support systems for asthma. A systematic review.
NPJ primary care respiratory medicine, 24, .
(doi:10.1038/npjpcrm.2014.5).
Abstract
BACKGROUND: Increasing use of electronic health records offers the potential to incorporate computer decision support systems (CDSSs) to prompt evidence-based actions within routine consultations.
AIM: To synthesise the evidence for the use of CDSSs by professionals managing people with asthma.
MATERIALS AND METHODS: We systematically searched Medline, Embase, Health Technology Assessment, Cochrane and Inspec databases (1990 to April 2012, no language restrictions) for trials, and four online repositories for unpublished studies. We also wrote to authors. Eligible studies were randomised controlled trials of CDSSs supporting professional management of asthma. Studies were appraised (Cochrane Risk of Bias Tool) and findings synthesised narratively.
RESULTS: A total of 5787 articles were screened, and eight trials were found eligible, with six at high risk of bias. Overall, CDSSs for professionals were ineffective. Usage of the systems was generally low: in the only trial at low risk of bias the CDSS was not used at all. When a CDSS was used, compliance with the advice offered was also low. However, if actually used, CDSSs could result in closer guideline adherence (improve investigating, prescribing and issuing of action plans) and could improve some clinical outcomes. The study at moderate risk of bias showed increased prescribing of inhaled steroids.
CONCLUSIONS: The current generation of CDSSs is unlikely to result in improvements in outcomes for patients with asthma because they are rarely used and the advice is not followed. Future decision support systems need to align better with professional workflows so that pertinent and timely advice is easily accessible within the consultation.
This record has no associated files available for download.
More information
Published date: 20 May 2014
Keywords:
Asthma, Clinical Trials as Topic, Decision Support Systems, Clinical, Humans, Outcome and Process Assessment (Health Care), Quality of Life, Treatment Outcome, Journal Article, Research Support, Non-U.S. Gov't, Review
Identifiers
Local EPrints ID: 414062
URI: http://eprints.soton.ac.uk/id/eprint/414062
ISSN: 2055-1010
PURE UUID: f6235972-ed61-4b47-9236-2e0e08250e22
Catalogue record
Date deposited: 13 Sep 2017 16:31
Last modified: 16 Mar 2024 04:23
Export record
Altmetrics
Contributors
Author:
Patricia Matui
Author:
Jeremy C. Wyatt
Author:
Hilary Pinnock
Author:
Aziz Sheikh
Author:
Susannah McLean
Download statistics
Downloads from ePrints over the past year. Other digital versions may also be available to download e.g. from the publisher's website.
View more statistics