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Computer-based clinical decision support systems and patient-reported outcomes : a systematic review

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Abstract
Evidence-based treatment guidelines embedded in computer-based clinical decision support systems (CCDSS) may improve patient-reported outcomes (PRO). We systematically reviewed the literature for content and application of CCDSS, and their effects on PRO. A systematic review in MEDLINE and EMBASE was conducted according to PRISMA standards. Searches were limited to the publication period 1996-May 2014 and the English language. The search terms covered "computerized clinical decision systems" and "patient-reported outcomes". Screening and extraction was done independently by two reviewers according to predefined inclusion (computer and guideline) and exclusion criteria (no trial, no PRO). Study and CCDSS quality was rated according to predefined criteria. The database searches identified 1,331 references. Eighty-seven full-text articles were analyzed. The main reason for exclusion was no PRO as a study outcome measure. Fifteen studies met the inclusion criteria, representing 13,480 patients. Nine studies used a computerized device to fill in data; in four studies, this was used by the patients themselves. Most of the studies presented the data to the clinician at point of care and incorporated international guidelines. Three studies showed a positive effect on PRO, but only on symptoms. Overall, no negative effects were reported. There was no association with study quality or year of study publication. There are marginal positive effects of CCDSS on specific PRO. Factors that facilitate the use and effect are identified. Easy to use systems with difficult to ignore evidence-based advice need to be developed and tested.
Keywords
RANDOMIZED CONTROLLED-TRIAL, PHYSICIAN ORDER ENTRY, QUALITY-OF-LIFE, PRIMARY-CARE, PRACTITIONER PERFORMANCE, MANAGEMENT, GUIDELINES, IMPROVE, SUGGESTIONS, DISEASE

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Chicago
Blum, David, Sunil X Raj, Rolf Oberholzer, Ingrid I Riphagen, Florian Strasser, Stein Kaasa, the EURO IMPACT group, et al. 2015. “Computer-based Clinical Decision Support Systems and Patient-reported Outcomes : a Systematic Review.” Patient-patient Centered Outcomes Research 8 (5): 397–409.
APA
Blum, David, Raj, S. X., Oberholzer, R., Riphagen, I. I., Strasser, F., Kaasa, S., EURO IMPACT group, the, et al. (2015). Computer-based clinical decision support systems and patient-reported outcomes : a systematic review. PATIENT-PATIENT CENTERED OUTCOMES RESEARCH, 8(5), 397–409.
Vancouver
1.
Blum D, Raj SX, Oberholzer R, Riphagen II, Strasser F, Kaasa S, et al. Computer-based clinical decision support systems and patient-reported outcomes : a systematic review. PATIENT-PATIENT CENTERED OUTCOMES RESEARCH. 2015;8(5):397–409.
MLA
Blum, David, Sunil X Raj, Rolf Oberholzer, et al. “Computer-based Clinical Decision Support Systems and Patient-reported Outcomes : a Systematic Review.” PATIENT-PATIENT CENTERED OUTCOMES RESEARCH 8.5 (2015): 397–409. Print.
@article{8514609,
  abstract     = {Evidence-based treatment guidelines embedded in computer-based clinical decision support systems (CCDSS) may improve patient-reported outcomes (PRO). We systematically reviewed the literature for content and application of CCDSS, and their effects on PRO. 
A systematic review in MEDLINE and EMBASE was conducted according to PRISMA standards. Searches were limited to the publication period 1996-May 2014 and the English language. The search terms covered {\textacutedbl}computerized clinical decision systems{\textacutedbl} and {\textacutedbl}patient-reported outcomes{\textacutedbl}. Screening and extraction was done independently by two reviewers according to predefined inclusion (computer and guideline) and exclusion criteria (no trial, no PRO). Study and CCDSS quality was rated according to predefined criteria. 
The database searches identified 1,331 references. Eighty-seven full-text articles were analyzed. The main reason for exclusion was no PRO as a study outcome measure. Fifteen studies met the inclusion criteria, representing 13,480 patients. Nine studies used a computerized device to fill in data; in four studies, this was used by the patients themselves. Most of the studies presented the data to the clinician at point of care and incorporated international guidelines. Three studies showed a positive effect on PRO, but only on symptoms. Overall, no negative effects were reported. There was no association with study quality or year of study publication. 
There are marginal positive effects of CCDSS on specific PRO. Factors that facilitate the use and effect are identified. Easy to use systems with difficult to ignore evidence-based advice need to be developed and tested.},
  author       = {Blum, David and Raj, Sunil X and Oberholzer, Rolf and Riphagen, Ingrid I and Strasser, Florian and Kaasa, Stein and EURO IMPACT group, the and Van den Block, Lieve and Cohen, Joachim and Pardon, Koen and Deliens, Luc},
  issn         = {1178-1653},
  journal      = {PATIENT-PATIENT CENTERED OUTCOMES RESEARCH},
  keyword      = {RANDOMIZED CONTROLLED-TRIAL,PHYSICIAN ORDER ENTRY,QUALITY-OF-LIFE,PRIMARY-CARE,PRACTITIONER PERFORMANCE,MANAGEMENT,GUIDELINES,IMPROVE,SUGGESTIONS,DISEASE},
  language     = {eng},
  number       = {5},
  pages        = {397--409},
  title        = {Computer-based clinical decision support systems and patient-reported outcomes : a systematic review},
  url          = {http://dx.doi.org/10.1007/s40271-014-0100-1},
  volume       = {8},
  year         = {2015},
}

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