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Laboratory test ordering in inpatient hospitals: a systematic review on the effects and features of clinical decision support systems

BACKGROUND: Studies have revealed inappropriate laboratory testing as a source of waste. This review aimed at evaluating the effects and features of CDSSs on physicians' appropriate laboratory test ordering in inpatient hospitals. METHOD: Medline through PubMed, SCOPUS, Web of Science, and Coch...

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Autores principales: Zare, Sahar, Meidani, Zahra, Shirdeli, Mohammad, Nabovati, Ehsan
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7814592/
https://www.ncbi.nlm.nih.gov/pubmed/33461548
http://dx.doi.org/10.1186/s12911-020-01384-8
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author Zare, Sahar
Meidani, Zahra
Shirdeli, Mohammad
Nabovati, Ehsan
author_facet Zare, Sahar
Meidani, Zahra
Shirdeli, Mohammad
Nabovati, Ehsan
author_sort Zare, Sahar
collection PubMed
description BACKGROUND: Studies have revealed inappropriate laboratory testing as a source of waste. This review aimed at evaluating the effects and features of CDSSs on physicians' appropriate laboratory test ordering in inpatient hospitals. METHOD: Medline through PubMed, SCOPUS, Web of Science, and Cochrane were queried without any time period restriction. Studies using CDSSs as an intervention to improve laboratory test ordering as the primary aim were included. The study populations in the included studies were laboratory tests, physicians ordering laboratory tests, or the patients for whom laboratory tests were ordered. The included papers were evaluated for their outcomes related to the effect of CDSSs which were categorized based on the outcomes related to tests, physician, and patients. The primary outcome measures were the number and cost of the ordered laboratory tests. The instrument from The National Heart Lung and Blood Institute (NIH) was used to assess the quality of the included studies. Moreover, we applied a checklist for assessing the quality and features of the CDSSs presented in the included studies. A narrative synthesis was used to describe and compare the designs and the results of included studies. RESULT: Sixteen studies met the inclusion criteria. Most studies were conducted based on a quasi-experimental design. The results showed improvement in laboratory test-related outcomes (e.g. proportion and cost of tests) and also physician-related outcomes (e.g. guideline adherence and orders cancellation). Patient-related outcomes (e.g. length of stay and mortality rate) were not well investigated in the included studies. In addition, the evidence about applying CDSS as a decision aid for interpreting laboratory results was rare. CONCLUSION: CDSSs increase appropriate test ordering in hospitals through eliminating redundant test orders and enhancing evidence-based practice. Appropriate testing and cost saving were both affected by the CDSSs. However, the evidence is limited about the effects of laboratory test CDSSs on patient-related outcomes.
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spelling pubmed-78145922021-01-19 Laboratory test ordering in inpatient hospitals: a systematic review on the effects and features of clinical decision support systems Zare, Sahar Meidani, Zahra Shirdeli, Mohammad Nabovati, Ehsan BMC Med Inform Decis Mak Research Article BACKGROUND: Studies have revealed inappropriate laboratory testing as a source of waste. This review aimed at evaluating the effects and features of CDSSs on physicians' appropriate laboratory test ordering in inpatient hospitals. METHOD: Medline through PubMed, SCOPUS, Web of Science, and Cochrane were queried without any time period restriction. Studies using CDSSs as an intervention to improve laboratory test ordering as the primary aim were included. The study populations in the included studies were laboratory tests, physicians ordering laboratory tests, or the patients for whom laboratory tests were ordered. The included papers were evaluated for their outcomes related to the effect of CDSSs which were categorized based on the outcomes related to tests, physician, and patients. The primary outcome measures were the number and cost of the ordered laboratory tests. The instrument from The National Heart Lung and Blood Institute (NIH) was used to assess the quality of the included studies. Moreover, we applied a checklist for assessing the quality and features of the CDSSs presented in the included studies. A narrative synthesis was used to describe and compare the designs and the results of included studies. RESULT: Sixteen studies met the inclusion criteria. Most studies were conducted based on a quasi-experimental design. The results showed improvement in laboratory test-related outcomes (e.g. proportion and cost of tests) and also physician-related outcomes (e.g. guideline adherence and orders cancellation). Patient-related outcomes (e.g. length of stay and mortality rate) were not well investigated in the included studies. In addition, the evidence about applying CDSS as a decision aid for interpreting laboratory results was rare. CONCLUSION: CDSSs increase appropriate test ordering in hospitals through eliminating redundant test orders and enhancing evidence-based practice. Appropriate testing and cost saving were both affected by the CDSSs. However, the evidence is limited about the effects of laboratory test CDSSs on patient-related outcomes. BioMed Central 2021-01-18 /pmc/articles/PMC7814592/ /pubmed/33461548 http://dx.doi.org/10.1186/s12911-020-01384-8 Text en © The Author(s) 2021 Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Research Article
Zare, Sahar
Meidani, Zahra
Shirdeli, Mohammad
Nabovati, Ehsan
Laboratory test ordering in inpatient hospitals: a systematic review on the effects and features of clinical decision support systems
title Laboratory test ordering in inpatient hospitals: a systematic review on the effects and features of clinical decision support systems
title_full Laboratory test ordering in inpatient hospitals: a systematic review on the effects and features of clinical decision support systems
title_fullStr Laboratory test ordering in inpatient hospitals: a systematic review on the effects and features of clinical decision support systems
title_full_unstemmed Laboratory test ordering in inpatient hospitals: a systematic review on the effects and features of clinical decision support systems
title_short Laboratory test ordering in inpatient hospitals: a systematic review on the effects and features of clinical decision support systems
title_sort laboratory test ordering in inpatient hospitals: a systematic review on the effects and features of clinical decision support systems
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7814592/
https://www.ncbi.nlm.nih.gov/pubmed/33461548
http://dx.doi.org/10.1186/s12911-020-01384-8
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