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J Am Med Inform Assoc. 2015 Apr;22(e1):e13-20. doi: 10.1093/jamia/ocu033. Epub 2015 Feb 8.

Comparative outcome studies of clinical decision support software: limitations to the practice of evidence-based system acquisition.

Author information

1
University of Miami Miller School of Medicine, Miami, FL, USA GJDhiman@Gmail.com.
2
University of Miami Miller School of Medicine, Miami, FL, USA.
3
Bioethics Program, University of Miami Miller School of Medicine, Miami, FL, USA.

Abstract

Clinical decision support systems (CDSSs) assist clinicians with patient diagnosis and treatment. However, inadequate attention has been paid to the process of selecting and buying systems. The diversity of CDSSs, coupled with research obstacles, marketplace limitations, and legal impediments, has thwarted comparative outcome studies and reduced the availability of reliable information and advice for purchasers. We review these limitations and recommend several comparative studies, which were conducted in phases; studies conducted in phases and focused on limited outcomes of safety, efficacy, and implementation in varied clinical settings. Additionally, we recommend the increased availability of guidance tools to assist purchasers with evidence-based purchases. Transparency is necessary in purchasers' reporting of system defects and vendors' disclosure of marketing conflicts of interest to support methodologically sound studies. Taken together, these measures can foster the evolution of evidence-based tools that, in turn, will enable and empower system purchasers to make wise choices and improve the care of patients.

KEYWORDS:

clinical decision support systems; comparative study; marketing; medical economics; medical ethics

PMID:
25665704
DOI:
10.1093/jamia/ocu033
[Indexed for MEDLINE]
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