Data quality in the outpatient setting: impact on clinical decision support systems - PubMed (original) (raw)
Data quality in the outpatient setting: impact on clinical decision support systems
Eta S Berner et al. AMIA Annu Symp Proc. 2005.
Abstract
Clinical decision support system (CDSS) performance may vary with the quality of the input data. We assessed the impact of medical record completeness and accuracy on a CDSS that provides risk assessment for gastrointestinal bleeding and recommends therapy when prescribing NSAIDs. We examined the documentation of six data elements in the medical record and the impact on the performance of the CDSS. We reviewed 178 transcribed clinical encounters from standardized patients with predefined clinical histories. Results showed that the mean completeness score across all encounters was .34. The mean correctness score for those elements present was .94. When the available data was input into the CDSS, the missing data elements resulted in inappropriate and unsafe recommendations in almost 77% of the encounters. The results show that important gaps in the medical record can affect the accuracy of a CDSS designed to improve safe prescribing.
Similar articles
- Improving ambulatory prescribing safety with a handheld decision support system: a randomized controlled trial.
Berner ES, Houston TK, Ray MN, Allison JJ, Heudebert GR, Chatham WW, Kennedy JI Jr, Glandon GL, Norton PA, Crawford MA, Maisiak RS. Berner ES, et al. J Am Med Inform Assoc. 2006 Mar-Apr;13(2):171-9. doi: 10.1197/jamia.M1961. Epub 2005 Dec 15. J Am Med Inform Assoc. 2006. PMID: 16357350 Free PMC article. Clinical Trial. - CDSS-RM: a clinical decision support system reference model.
Zikos D, DeLellis N. Zikos D, et al. BMC Med Res Methodol. 2018 Nov 16;18(1):137. doi: 10.1186/s12874-018-0587-6. BMC Med Res Methodol. 2018. PMID: 30445910 Free PMC article. - The prompt, the alert, and the legal record: documenting clinical decision support systems.
Rollins G. Rollins G. J AHIMA. 2005 Feb;76(2):24-8; quiz 31-2. J AHIMA. 2005. PMID: 15739950 No abstract available. - Reducing medication errors for adults in hospital settings.
Ciapponi A, Fernandez Nievas SE, Seijo M, Rodríguez MB, Vietto V, García-Perdomo HA, Virgilio S, Fajreldines AV, Tost J, Rose CJ, Garcia-Elorrio E. Ciapponi A, et al. Cochrane Database Syst Rev. 2021 Nov 25;11(11):CD009985. doi: 10.1002/14651858.CD009985.pub2. Cochrane Database Syst Rev. 2021. PMID: 34822165 Free PMC article. Review. - Improving Antimicrobial Prescriptions with Computerized Decision Support Systems: Where Are We?
Nageeti T, Al-Harbi R, Al-Malki K, Natto O, Binhamdan A, Aldosari H, Aldosari B, Alshammari F, Alanazi A. Nageeti T, et al. Stud Health Technol Inform. 2019 Jul 4;262:138-141. doi: 10.3233/SHTI190036. Stud Health Technol Inform. 2019. PMID: 31349285 Review.
Cited by
- Disease diagnosis in primary care in Uganda.
Mbonye MK, Burnett SM, Colebunders R, Naikoba S, Van Geertruyden JP, Weaver MR, Ronald A. Mbonye MK, et al. BMC Fam Pract. 2014 Oct 8;15:165. doi: 10.1186/1471-2296-15-165. BMC Fam Pract. 2014. PMID: 25298081 Free PMC article. - Human- Versus Machine Learning-Based Triage Using Digitalized Patient Histories in Primary Care: Comparative Study.
Entezarjou A, Bonamy AE, Benjaminsson S, Herman P, Midlöv P. Entezarjou A, et al. JMIR Med Inform. 2020 Sep 3;8(9):e18930. doi: 10.2196/18930. JMIR Med Inform. 2020. PMID: 32880578 Free PMC article. - Differences in changes of data completeness after the implementation of an electronic medical record in three surgical departments of a German hospital-a longitudinal comparative document analysis.
Wurster F, Herrmann C, Beckmann M, Cecon-Stabel N, Dittmer K, Hansen T, Jaschke J, Köberlein-Neu J, Okumu MR, Pfaff H, Rusniok C, Karbach U. Wurster F, et al. BMC Med Inform Decis Mak. 2024 Sep 16;24(1):258. doi: 10.1186/s12911-024-02667-0. BMC Med Inform Decis Mak. 2024. PMID: 39285457 Free PMC article. - Recommended practices for computerized clinical decision support and knowledge management in community settings: a qualitative study.
Ash JS, Sittig DF, Guappone KP, Dykstra RH, Richardson J, Wright A, Carpenter J, McMullen C, Shapiro M, Bunce A, Middleton B. Ash JS, et al. BMC Med Inform Decis Mak. 2012 Feb 14;12:6. doi: 10.1186/1472-6947-12-6. BMC Med Inform Decis Mak. 2012. PMID: 22333210 Free PMC article. - Expectation of clinical decision support systems: a survey study among nephrologist end-users.
Kotsis F, Bächle H, Altenbuchinger M, Dönitz J, Njipouombe Nsangou YA, Meiselbach H, Kosch R, Salloch S, Bratan T, Zacharias HU, Schultheiss UT. Kotsis F, et al. BMC Med Inform Decis Mak. 2023 Oct 26;23(1):239. doi: 10.1186/s12911-023-02317-x. BMC Med Inform Decis Mak. 2023. PMID: 37884906 Free PMC article.
References
- Pestotnik SL, Classen DC, Evans RS, Burke JP. Implementing Antibiotic Practice Guidelines through Computer-Assisted Decision Support: Clinical and Financial Outcomes. Ann Intern Med. 1996;124:884–90. - PubMed
- Bates DW, Gawande AA. Improving safety with information technology. N Engl J Med. 2003;348:2526–34. - PubMed
- Garg AX, Adhikari NKJ, McDonald H, et al. Effects of Computerized clinical decision support systems on physician performance and patient outcomes. JAMA. 2005;293:1339–46. - PubMed
Publication types
MeSH terms
Substances
LinkOut - more resources
Full Text Sources