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A systematic review on the effectiveness and impact of clinical decision support systems for breathlessness

Breathlessness is a common presenting symptom in practice. This systematic review aimed to evaluate the impact of CDSS on breathlessness and associated diseases in real-world clinical settings. Studies published between 1 January 2000 to 10 September 2021 were systematically obtained from 14 electro...

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Autores principales: Sunjaya, Anthony P., Ansari, Sameera, Jenkins, Christine R.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Nature Publishing Group UK 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9392800/
https://www.ncbi.nlm.nih.gov/pubmed/35987745
http://dx.doi.org/10.1038/s41533-022-00291-x
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author Sunjaya, Anthony P.
Ansari, Sameera
Jenkins, Christine R.
author_facet Sunjaya, Anthony P.
Ansari, Sameera
Jenkins, Christine R.
author_sort Sunjaya, Anthony P.
collection PubMed
description Breathlessness is a common presenting symptom in practice. This systematic review aimed to evaluate the impact of CDSS on breathlessness and associated diseases in real-world clinical settings. Studies published between 1 January 2000 to 10 September 2021 were systematically obtained from 14 electronic research databases including CENTRAL, Embase, Pubmed, and clinical trial registries. Main outcomes of interest were patient health outcomes, provider use, diagnostic concordance, economic evaluation, and unintended consequences. The review protocol was prospectively registered in PROSPERO (CRD42020163141). A total of 4294 records were screened and 37 studies included of which 30 were RCTs. Twenty studies were in primary care, 13 in hospital outpatient/emergency department (ED), and the remainder mixed. Study duration ranged from 2 weeks to 5 years. Most were adults (58%). Five CDSS were focused on assessment, one on assessment and management, and the rest on disease-specific management. Most studies were disease-specific, predominantly focused on asthma (17 studies), COPD (2 studies), or asthma and COPD (3 studies). CDSS for COPD, heart failure, and asthma in adults reported clinical benefits such as reduced exacerbations, improved quality of life, improved patient-reported outcomes or reduced mortality. Studies identified low usage as the main barrier to effectiveness. Clinicians identified dissonance between CDSS recommendations and real-world practice as a major barrier. This review identified potential benefits of CDSS implementation in primary care and outpatient services for adults with heart failure, COPD, and asthma in improving diagnosis, compliance with guideline recommendations, promotion of non-pharmacological interventions, and improved clinical outcomes including mortality.
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spelling pubmed-93928002022-08-22 A systematic review on the effectiveness and impact of clinical decision support systems for breathlessness Sunjaya, Anthony P. Ansari, Sameera Jenkins, Christine R. NPJ Prim Care Respir Med Review Article Breathlessness is a common presenting symptom in practice. This systematic review aimed to evaluate the impact of CDSS on breathlessness and associated diseases in real-world clinical settings. Studies published between 1 January 2000 to 10 September 2021 were systematically obtained from 14 electronic research databases including CENTRAL, Embase, Pubmed, and clinical trial registries. Main outcomes of interest were patient health outcomes, provider use, diagnostic concordance, economic evaluation, and unintended consequences. The review protocol was prospectively registered in PROSPERO (CRD42020163141). A total of 4294 records were screened and 37 studies included of which 30 were RCTs. Twenty studies were in primary care, 13 in hospital outpatient/emergency department (ED), and the remainder mixed. Study duration ranged from 2 weeks to 5 years. Most were adults (58%). Five CDSS were focused on assessment, one on assessment and management, and the rest on disease-specific management. Most studies were disease-specific, predominantly focused on asthma (17 studies), COPD (2 studies), or asthma and COPD (3 studies). CDSS for COPD, heart failure, and asthma in adults reported clinical benefits such as reduced exacerbations, improved quality of life, improved patient-reported outcomes or reduced mortality. Studies identified low usage as the main barrier to effectiveness. Clinicians identified dissonance between CDSS recommendations and real-world practice as a major barrier. This review identified potential benefits of CDSS implementation in primary care and outpatient services for adults with heart failure, COPD, and asthma in improving diagnosis, compliance with guideline recommendations, promotion of non-pharmacological interventions, and improved clinical outcomes including mortality. Nature Publishing Group UK 2022-08-20 /pmc/articles/PMC9392800/ /pubmed/35987745 http://dx.doi.org/10.1038/s41533-022-00291-x Text en © The Author(s) 2022 https://creativecommons.org/licenses/by/4.0/Open Access This 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 license, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons license, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons license 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 license, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) .
spellingShingle Review Article
Sunjaya, Anthony P.
Ansari, Sameera
Jenkins, Christine R.
A systematic review on the effectiveness and impact of clinical decision support systems for breathlessness
title A systematic review on the effectiveness and impact of clinical decision support systems for breathlessness
title_full A systematic review on the effectiveness and impact of clinical decision support systems for breathlessness
title_fullStr A systematic review on the effectiveness and impact of clinical decision support systems for breathlessness
title_full_unstemmed A systematic review on the effectiveness and impact of clinical decision support systems for breathlessness
title_short A systematic review on the effectiveness and impact of clinical decision support systems for breathlessness
title_sort systematic review on the effectiveness and impact of clinical decision support systems for breathlessness
topic Review Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9392800/
https://www.ncbi.nlm.nih.gov/pubmed/35987745
http://dx.doi.org/10.1038/s41533-022-00291-x
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