Muhiyaddin Raghad, Abd-Alrazaq Alaa A, Househ Mowafa, Alam Tanvir, Shah Zubair
College of Science & Engineering, Hamad bin Khalifa University, Doha, Qatar.
Stud Health Technol Inform. 2020 Jun 26;272:470-473. doi: 10.3233/SHTI200597.
Clinical Decision Support Systems (CDSSs) are used in a clinical setting to help physicians make decisions to improve clinical performance and patient care. There are many benefits to the implementation and adoption of CDSSs, such as reducing the rate of misdiagnosis, improving efficiency and patient care, and reducing the risk of medication errors. On the other hand, CDSSs can have several disadvantages. For example, physicians can see CDSSs as a threat to their clinical autonomy. CDSSs can also be very costly to adopt, maintain, and support. These advantages and disadvantages can have both positive and negative impacts on physicians. We conducted a scoping review to explore the impact of CDSSs on physicians. We searched the following electronic databases: CINAHL, PubMed, and Google Scholar. Two reviewers independently selected the retrieved studies and extracted data from the included studies. A narrative approach was used to synthesize the extracted data. We included 14 studies of the 300 retrieved studies. We identified the following positive impacts: work efficiency, providing more personalized care, improving care and knowledge, increasing confidence in making decisions, improving prescribing behavior, and reducing the number of ordered laboratory and medical imaging tests. Several negative impacts were also reported by the studies, namely: inefficient documentation, interruption in the patient-physician communication, and an increase in unnecessary referrals.
临床决策支持系统（CDSSs）用于临床环境，以帮助医生做出决策，从而提高临床绩效和患者护理水平。实施和采用CDSSs有诸多益处，比如降低误诊率、提高效率和患者护理质量，以及降低用药错误风险。另一方面，CDSSs也可能存在一些缺点。例如，医生可能将CDSSs视为对其临床自主权的威胁。采用、维护和支持CDSSs的成本也可能非常高昂。这些优点和缺点可能对医生产生积极和消极的影响。我们进行了一项范围综述，以探讨CDSSs对医生的影响。我们检索了以下电子数据库：护理学与健康领域数据库（CINAHL）、医学期刊数据库（PubMed）和谷歌学术。两名评审员独立筛选检索到的研究，并从纳入研究中提取数据。采用叙述性方法对提取的数据进行综合分析。在检索到的300项研究中，我们纳入了14项研究。我们确定了以下积极影响：工作效率、提供更个性化的护理、改善护理和知识水平、增强决策信心、改善处方行为，以及减少所开具的实验室检查和医学影像检查的数量。研究还报告了一些负面影响，即：记录效率低下、医患沟通中断，以及不必要转诊增加。
