Document Detail

The role of Decision Support System (DSS) in prevention of cardiovascular disease: a systematic review and meta-analysis.
MedLine Citation:
PMID:  23071713     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: The potential role of DSS in CVD prevention remains unclear as only a few studies report on patient outcomes for cardiovascular disease.
METHODS AND RESULTS: A systematic review and meta-analysis of randomised controlled trials and observational studies was done using Medline, Embase, Cochrane Library, PubMed, Amed, CINAHL, Web of Science, Scopus databases; reference lists of relevant studies to 30 July 2011; and email contact with experts. The primary outcome was prevention of cardiovascular disorders (myocardial infarction, stroke, coronary heart disease, peripheral vascular disorders and heart failure) and management of hypertension owing to decision support systems, clinical decision supports systems, computerized decision support systems, clinical decision making tools and medical decision making (interventions). From 4116 references ten studies met our inclusion criteria (including 16,312 participants). Five papers reported outcomes on blood pressure management, one paper on heart failure, two papers each on stroke, and coronary heart disease. The pooled estimate for CDSS versus control group differences in SBP (mm of Hg) was - 0.99 (95% CI -3.02 to 1.04 mm of Hg; I(2) = 0; p = 0.851).
CONCLUSIONS: DSS show an insignificant benefit in the management and control of hypertension (insignificant reduction of SBP). The paucity of well-designed studies on patient related outcomes is a major hindrance that restricts interpretation for evaluating the role of DSS in secondary prevention. Future studies on DSS should (1) evaluate both physician performance and patient outcome measures (2) integrate into the routine clinical workflow with a provision for decision support at the point of care.
Raghupathy Anchala; Maria P Pinto; Amir Shroufi; Rajiv Chowdhury; Jean Sanderson; Laura Johnson; Patricia Blanco; Dorairaj Prabhakaran; Oscar H Franco
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Publication Detail:
Type:  Journal Article; Meta-Analysis; Research Support, Non-U.S. Gov't; Review     Date:  2012-10-10
Journal Detail:
Title:  PloS one     Volume:  7     ISSN:  1932-6203     ISO Abbreviation:  PLoS ONE     Publication Date:  2012  
Date Detail:
Created Date:  2012-10-16     Completed Date:  2013-05-01     Revised Date:  2014-03-19    
Medline Journal Info:
Nlm Unique ID:  101285081     Medline TA:  PLoS One     Country:  United States    
Other Details:
Languages:  eng     Pagination:  e47064     Citation Subset:  IM    
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MeSH Terms
Cardiovascular Diseases / prevention & control*
Coronary Artery Disease / prevention & control
Decision Support Systems, Clinical / statistics & numerical data*
Heart Failure / prevention & control
Hypertension / prevention & control,  therapy
Myocardial Infarction / prevention & control
Grant Support
084754//Wellcome Trust; //Wellcome Trust

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