Table 3.

Taxonomy of clinical decision support (CDS) tools and survey results: medication dosing support

CDS type	CDS description	Example	Vendor							Total	Institution				Total	Grand total
			1	2	3	4	5	6	7		1	2	3	4
Medication dosing support
Medication dose adjustment26	Assistance with adjusting or calculating medication doses based on patient characteristics such as age, weight, or renal or hepatic function.	An algorithm that automatically suggests that if CrCl<50 mg/min, reduce frequency of administration of a particular medication to every 24 h.	•	•	•	•	•	•	•	7	•	•		•	3	10
Formulary checking27	Check medication orders against hospital or payer formularies and suggest more cost-effective therapies.	Suggest omeprazole as a more cost effective alternative to pantoprazole.	•	•	•	•	•		•	6	•	•	•	•	4	10
Single dose range checking28	Checking to see whether a single dose of a medication falls outside of an allowable dose range	Alert on a single dose of acetaminophen ≥1 g.	•	•	•		•	•	•	6	•	•		•	3	9
Maximum daily dose checking29	Checking to see whether the combined daily dose of a medication exceeds a specified maximum daily dose. In the case of combination products (such as hydrocodone/acetaminophen), systems should check each ingredient for maximum daily dose, in combination with other medications the patient is receiving.	Alert on a total daily dose of acetaminophen ≥4 g.	•	•	•	•	•	•	•	7	•			•	2	9
Maximum lifetime dose checking29	Checking to see whether the combined lifetime dose of a medication exceeds a specified maximum lifetime dose.	Alert if the total cumulative dose of doxorubicin over a patient's lifetime exceeds 550 mg/m2.	•				•	•		3	•				1	4
Default doses/pick lists27	Providing common doses of a medication for a provider to choose from.	Providing a list of 100 mg, 200 mg, 300 mg, 400 mg, 600 mg, and 800 mg doses for ibuprofen with a default of 400 mg.	•	•	•	•	•	•	•	7	•	•	•	•	4	11
Indication-based dosing30	Adjusting default medication doses based on indications entered by ordering provider.	Order 7.5 mg methotrexate once weekly for rheumatoid arthritis, but 1500 mg/m2 every 4 weeks (with leucovorin rescue) for gastric cancer.	•	•	•	•	•	•		6	•	•		•	3	9
Totals (absence of ‘•’ indicates response of N (no), NA (not applicable), or (blank))			7	6	6	5	7	6	5	42	7	5	2	6	20	62