Table 1.
Summary of Included Studies and Outcome Measures.
| Author, year | JBI Quality Score | Study Purpose | Disease or symptom | Study design | No. of sites/providers/patients | Process outcome(s) | Statistically significant benefit of intervention on process outcome? | Patient outcome(s) | Patient-reported | Statistically significant benefit of intervention on patient outcome? | CDS informed from guideline | EHR-integration |
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| [38] | 8 | To test the impact of a CDSS on prescriber deviations from CDS recommendation for CPG-based pain management in cancer patients | Pain | Pre-post | 1/NA/100 | Decreased number of patients with at least 1 CPG deviation from 84% to 14% (p < 0.001) | Yes | Pain at rest by NVAS in intervention group decreased from 3.0 to 1.5 compared to discharge (p < .01) and during activitiy decreased from 7.0 to 2.5 (p < .001) in intervention group | Yes | Yes | Yes | Yes |
| [33] | 4 | To test the adherence of physician’s treatment decision compared to that provided by a CDSS in breast cancer patients | Breast cancer | Single-arm pilot study | 1/13/127 | Overall compliance with CDSS recommendation: 61.42% vs 85.03% (p < 0.001) | Yes | NA | No | NA | Yes | No |
| [34] | 3 | To test the adherence of physician’s treatment decision (2nd site studied) compared to that provided by a CDSS in breast cancer patients | Breast cancer | Single-arm pilot study | 1/NR/NR | Overall compliance with CDSS recommendation: 55% | NA | NA | No | NA | Yes | No |
| [39] | 7 | To test the impact of a CDSS on pharmacist deviations from CDS recommendation for CPG-based pain management in cancer patients | Pain | Pre-post | 2/14/88 | NCCN-CPG adherent pain regimen prescribed not changed (40% vs. 46.9% p = 0.97) | No | Patient-reported attainment of analgesia at 24h: 10.5% improvement (33.3% vs 43.8%, p = .78) | Yes | No | Yes | Yes |
| [31] | 7 | To test the feasibility of symptom screening linked to CDSS for clinicians to manage symptoms | Symptoms (multiple) | Single-arm pilot study | 1/14/88 | Adherence of provider to CDS recommendation averaged 57% (95% Cl: 52–62%) | NA | NA | Yes | NA | Yes | No |
| [37] | 8 | To test the implementation of the Distress Assessment and Response Tool (DART) | Emotional distress | Pre-post | 1/16/196 | Intervention for depression increased from 7% to 33% (p < .001) | Yes | Patients with intervention reported significantly greater satisfaction with emotional support (no further results available); patients with low income reported greater satisfaction with emotional support (8.67 v 5.75, p < .001) and treatment support (9.23 v 7.68, p < .05) | Yes | Yes | Yes | Yes |
| [36] | 8 | To test the effect of routine symptom screening linked to CPG-based CDS for clinician follow-up on the patient’s symptom severity | Symptoms (multiple) | RCT | 6/NR/358 | NA | NA | Mean treatment impact for intervention group was 3.59 severity points (p < 0.001), 43% of the non-intervention group value. Intervention group had 3x fewer severe days (p < .001) than usual care. 10 of 11 measured symptoms were significantly lower for intervention group (p.025 to < .001). | Yes | Yes | Yes | No |
| [40] | 9 | To test the impact of a CDS for prescribers on patient-reported pain intensity levels and opioid prescribing practices in cancer patients | Pain | Pre-post | 1/NR/247 | Proportion of patients starting a new opioid medication was not statistically different between groups (8.8% vs. 10.5%, p = 0.69) | No | Mean pain intensity score were 3.6 and 3.3 between pre- and post-intervention groups (between group difference = 0.12, 95% Cl: −0.33 – 0.58) | Yes | No | Yes | No |
| [32] | 8 | To test the impact of a CDSS for breast oncologists when determining treatment plan for cancer patients | Breast cancer | Single-arm pilot study | 2/12/70 | Site 1: Adherence 96.6%, compliance 64.28%; Site 2: Adherence 79%, Compliance 88%. (From Escher: increased compliance rate of decisions from 79% to 93%) | Yes | NA | No | NA | Yes | No |
| [41] | 6 | To test the impact of an anemia-management CDSS on clinicians’ management of cancer patients with anemia | Anemia | Pre-post | 1/NR/68 | Improvement in mean congruence scores to CPG between pre- and postcohort (3.00 + −1.48 compared to 8.18 + −1.38, p < 0.001) | Yes | Mean hemoglobin levels significantly increased in postcohort (0.80 + − 1.51 compared to 1.90 + − 1.61, p < .01) and patients in postcohort more likely to have Hb > =11 g/dL (OR3.64 (1.12–11.80, p = 0.03)) | No | Yes | Yes | No |