Table 6.2. Studies of clinical decision support systems (CDSSs)*

StudyStudy DesignStudy OutcomesResults
Hunt, 1998. 25 Use of CDSSs by healthcare practitioners in multiple inpatient and outpatient settingsLevel 1A
(systematic review of RCTs)
Levels 1 & 2 (a variety of measures related to patient outcomes and physician practice, not just ADEs and processes of care related to medication use.6 of 14 studies showed improvement in patient outcomes
43 of 65 studies showed improvement in physician performance
Walton, 2001. 26 Use of CDSSs for drug dosage advice by healthcare practitioners for 1229 patients in multiple inpatient settingsLevels 1A-3A
(systematic review of RCTs, interrupted time series analyses, and controlled before-after studies)
Level 1 (one main outcome measure was adverse drug reactionsAbsolute risk reduction with CDSSs: 6% (95% CI: 0-12%)
Evans, 1994. 27 Use of a computerized antibiotic selection consultant for 451 inpatients at Salt Lake City's LDS Hospital, a 520-bed community teaching hospital and tertiary referral centerLevel 1 (RCT with crossover design)Level 2 (one of 5 primary outcomes was pathogen susceptibility to prescribed antibiotic regimens17% greater pathogen susceptibility to an antibiotic regimen suggested by computer consultant versus physicians (p<0.001)
Evans, 1998. 28 Computer-based anti-infective management program for 1136 intensive care unit patients from a 12-bed ICU at LDS HospitalLevel 2
(prospective before-after analysis)
Level 2 (one primary outcome was ADEs due to anti-infective agents70% decrease in ADEs caused by anti-infectives (p=0.02)

* ADE indicates adverse drug event; CI, confidence interval; ICU, intensive care unit; and RCT, randomized controlled trial.

From: 6, Computerized Physician Order Entry (CPOE) with Clinical Decision Support Systems (CDSSs)

Cover of Making Health Care Safer
Making Health Care Safer: A Critical Analysis of Patient Safety Practices.
Evidence Reports/Technology Assessments, No. 43.
Shojania KG, Duncan BW, McDonald KM, et al., editors.

NCBI Bookshelf. A service of the National Library of Medicine, National Institutes of Health.