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. 2024 Aug 24;31(1):e101046. doi: 10.1136/bmjhci-2024-101046

Table 2. Characteristics of included CDS and sources of evidence. References contained in online supplemental file 5.

Author and year Medical domain Setting and country Commercial name for CDSS CDS underlying method Papers referenced or documentation
Gibbs 2020 (A) Hypoglycaemia management Secondary care, USA Not reported Clinical guidelines Using a Clinical Support System to Facilitate Nurses’ Adherence to Treatment Protocols for Hypoglycaemia(A)
Macpherson 2020 (B) Liver function testing Primary care, UK iLFT Consensus algorithm

  1. Intelligent Liver Function Testing: Working Smarter to Improve Patient Outcomes in Liver Disease(B)

  2. iLFT: A trial of automated diagnosis and staging of liver disease in primary care(C).

  3. o21 Intelligent liver function testing: 18 months of real-world data(D).

  4. Development and validation of diagnostic triage criteria for liver disease from a minimum data set enabling the 'intelligent LFT' pathway for the automated assessment of deranged liver enzymes(E).
Hart 2013 (F) Chronic low back pain Primary care, UK Start Back Regression

  1. Sheffield spinal pathway audit cycle(F)

  2. https://startback.hfac.keele.ac.uk/training/resources/startback-online/(G)
Sendak 2020 (H) Sepsis Emergency department, USA Sepsis Watch Deep learning

  1. Real-World Integration of a Sepsis Deep Learning Technology Into Routine Clinical Care: Implementation Study(H).

  2. Sepsis watch: a successful deployment of a deep learning sepsis detection and treatment platform(I).

  3. https://dihi.org/project/sepsiswatch/(J).
Ellis 2013 (K) Cancer Oncology specialist services, USA https://www.elsevier.com/solutions/clinicalpath/publications Expert committee designed

  1. Development and Implementation of Oncology Care Pathways in an Integrated Care Network: The Via Oncology Pathways Experience(K).

  2. .Leveraging Evidence-based Oncology Pathways to Inform Multidisciplinary Tumour Board Decisions in Melanoma (L).
Hammar 2020 (M) Polypharmacy Community pharmacy, Sweden Electronic Expert Support Live analysis of medical record against drug formulary

  1. The Use of a Decision Support System in Swedish Pharmacies to Identify Potential Drug-Related Problems—Effects of a National Intervention Focused on Reviewing Elderly Patients Prescriptions(M).

  2. Potential drug-related problems detected by electronic expert support system, physicians’ views on clinical relevance(N).

  3. https://www.ehalsomyndigheten.se/yrkesverksam/apotek/ees-elektroniskt-expertstod/(O).
Nix 2021 (P) Clostridioides difficile (C-Diff) testing Secondary care, USA Testing algorithm embedded as a link into the order screen on EHR Algorithm Impact of a Clostridioides difficile testing computerised CDS tool on an adult stem cell transplantation and haematological malignancies unit.(P).
Hashemi(Q) Paediatric prescriptions in ICU PICU, Netherlands Automatic calculation of recommended dosage programmed into the EHR Formulary guidelines

  1. The effect of a decision support system on the incidence of prescription errors in a PICU(Q).

  2. van der Zanden: Developing a paediatric drug formulary for the Netherlands(R) (the CDSS was based on this formulary).
Arain 2020 (S) Pre-term infants Maternity, USA Premie BiliRecs | CDS| Stanford Children’s Heath (stanfordchildrens.org) Expert consensus guidelines

  1. CDS tool for phototherapy initiation in preterm infants(S).

  2. Tool is based on Maisels 2012: An approach to the management of hyperbilirubinaemia in the preterm infant less than 35 weeks of gestation(T).

  3. Development of a web-based decision support tool to operationalise and optimise management of hyperbilirubinaemia in preterm infants(U).
George 2020 (V) Venous thromboembolism Secondary care, USA Not reported Clinical guidelines Impact of a Clinical Decision-Support Tool on Venous Thromboembolism Prophylaxis in Acutely Ill Medical Patients.(V)
Impact of a venous thromboembolism prophylaxis ‘smart order set’: Improved compliance, fewer events(W).
Dugdale 2021 (X) COVID-19 Secondary care, USA Not reported Scoring algorithm

  1. COVID-19 Diagnostic CDS: A Pre-Post Implementation Study of CORAL (COvid Risk cALculator)(X)

  2. Outcomes from an infection disease physician guided evaluation of hospitalised persons under investigation for coronavirus disease 2019 at a large US academic medical centre.(Y)
Marcial 2019 (Z) Radiology Primary care and emergency department, USA Two tools: ‘Imaging Advantage’ has now been expanded into Envision Altarum ImageSmart has now been incorporated into their EPR solution Not reported for either system

  1. A qualitative framework-based evaluation of radiology CDS initiatives: eliciting key factors to physician adoption in implementation(Z).

  2. https://www.envisionphysicianservices.com/explore-solutions/radiology (AA)

  3. https://www.alterahealth.com/solution/touchworks/ (BB)
Jeffries 2021 (CC) Medication safety Primary care, UK Software is commercially developed but the study does not name the software. Reference to ‘SMASH’ dashboard Not reported

  1. The implementation, use and sustainability of a CDS system for medication optimisation in primary care: A qualitative evaluation (CC).

  2. Understanding the utilisation of a novel interactive electronic medication safety dashboard in general practice: a mixed methods study. (DD)

  3. Evaluation of a pharmacist-led actionable audit and feedback intervention for improving medication safety in UK primary care: an interrupted time series analysis. (EE)
Kan 2019 (FF) Intravenous to oral antibiotic conversion Community hospital, USA Bespoke tool developed in house. Clinical guidelines Implementation of a CDST to improve antibiotic intravenous to oral conversion rates at a community academic hospital (FF)
Johansson-Pajala 2019 (GG) Drug monitoring in elderly patients Nursing home, Sweden Bespoke tool developed in house Live analysis of medical record against drug formulary

  1. Conditions for the Successful Implementation of Computer-Aided Drug Monitoring From Registered Nurses' Perspective: A Case Site Analysis (GG)

  2. Registered nurses' use of computerised decision support in medication reviews implications in Swedish Nursing homes. (HH)

  3. Nurses' use of computerised decision support systems affects drug monitoring in nursing homes. (II)
Lee 2021 (JJ) Radiology (back pain) Primary care, USA Not reported Appropriateness score—not reported how the score is calculated

  1. Quality improvement time-saving intervention to increase use of a CDS tool to reduce low-value diagnostic imaging in a safety net health system (JJ)

Background to why low value care is being targeted, but nothing specific to this CDS
Heard 2019 (KK) Antimicrobial stewardship Secondary care, UK ICNET Live analysis of medical record against drug formulary

  1. Evaluating the impact of the ICNET CDS system for antimicrobial stewardship (KK)

  2. https://www.icnetsoftware.com/ (LL)
Wilkinson et al, 2019 (MM) Diabetes Secondary care, Australia Not reported Decision tree

  1. Implementing a best-practice model of gestational diabetes mellitus care in dietetics: a qualitative study (MM)

  2. Clinically relevant improvements achieved from a facilitated implementation of a gestational diabetes model of care (NN)
Staples, 2020 (OO) Blood transfusion Secondary care, UK Not reported Live analysis of blood results against clinical guidelines

  1. How do we use electronic CDS and feedback to promote good transfusion practice (OO)

  2. Implementation of a CDS system improves compliance with restrictive transfusion policies in haematology patients (PP)

  3. Economic value of CDS allied to direct data feedback to clinicians: blood use in haematology (QQ)
Shah et al, 2020 (RR) Prostate cancer Primary care, USA Bespoke tool for EHR Algorithm

  1. Implementation and Impact of a Risk-Stratified Prostate Cancer Screening Algorithm as a CDS Tool in a Primary Care Network (RR)

  2. Primary care perspective and implementation of a multidisciplinary institutional prostate cancer screening algorithm embedded in the EHR (SS)

  3. Implementation of a novel PSA screening algorithm - Duke Institute for Health Innovation dihi.org (TT)
Delory et al, 2020 (UU) Antimicrobial stewardship Primary care, France https://antibioclic.com/ Decision tree for clinical guidelines

  1. A CDSS for antibiotic prescription in primary care: Antibioclic: implementation, adoption and sustainable use in the era of extended antimicrobial resistance (UU)

  2. Paving the way for the implementation of a decision support system for antibiotic prescribing in primary care in west Africa: preimplementation and codesign workshop with physicians. (VV)
Meador et al, 2014 (XX) Burns resuscitation Secondary care, USA Arcos Burn Navigator Best fit function on retrospective data

  1. Clinician Satisfaction With Computer Decision Support in the ICU (XX)

  2. Computerised decision support system improves fluid resuscitation following severe burns: An original study (YY)

  3. Decision assist method of resuscitation of patients (ZZ)

  4. Burn Navigator (AAA)

CDS, clinical decision support; CDSS, computerised decision support system; EHR, electronic health record; ICU, intensive care unit; iLFT, Intelligent liver function testing; PICU, paediatric ICU.