Centre for Trauma Sciences, Blizard Institute, Queen Mary University of London, London, UK.
Royal London Hospital, Barts Health NHS Trust, London, UK.
BMC Med Inform Decis Mak. 2024 Nov 1;24(1):323. doi: 10.1186/s12911-024-02739-1.
The primary aim of this scoping review was to synthesise key domains and sub-domains described in existing clinical decision support systems (CDSS) implementation frameworks into a novel taxonomy and demonstrate most-studied and least-studied areas. Secondary objectives were to evaluate the frequency and manner of use of each framework, and catalogue frameworks by implementation stage.
A scoping review of Pubmed, Scopus, Web of Science, PsychInfo and Embase was conducted on 12/01/2022, limited to English language, including 2000-2021. Each framework was categorised as addressing one or multiple stages of implementation: design and development, evaluation, acceptance and integration, and adoption and maintenance. Key parts of each framework were grouped into domains and sub-domains.
Of 3550 titles identified, 58 papers were included. The most-studied implementation stage was acceptance and integration, while the least-studied was design and development. The three main framework uses were: for evaluating adoption, for understanding attitudes toward implementation, and for framework validation. The most frequently used framework was the Consolidated Framework for Implementation Research.
Many frameworks have been published to overcome barriers to CDSS implementation and offer guidance towards successful adoption. However, for co-developers, choosing relevant frameworks may be a challenge. A taxonomy of domains addressed by CDSS implementation frameworks is provided, as well as a description of their use, and a catalogue of frameworks listed by the implementation stages they address. Future work should ensure best practices for CDSS design are adequately described, and existing frameworks are well-validated. An emphasis on collaboration between clinician and non-clinician affected parties may help advance the field.
本范围综述的主要目的是将现有临床决策支持系统 (CDSS) 实施框架中描述的主要领域和子领域综合到一个新的分类系统中，并展示研究最多和研究最少的领域。次要目标是评估每个框架的使用频率和方式，并按实施阶段对框架进行分类。
于 2022 年 1 月 12 日在 Pubmed、Scopus、Web of Science、PsychInfo 和 Embase 上进行了一次范围综述，仅限于英文，包括 2000-2021 年的文献。每个框架都被归类为解决实施的一个或多个阶段：设计和开发、评估、接受和整合以及采用和维护。每个框架的关键部分被分为领域和子领域。
在 3550 个标题中，有 58 篇论文被纳入。研究最多的实施阶段是接受和整合，而最少的是设计和开发。使用框架的三个主要用途是：评估采用情况、了解对实施的态度以及验证框架。使用最频繁的框架是整合实施研究框架。
已经发布了许多框架来克服 CDSS 实施的障碍，并为成功采用提供指导。然而，对于共同开发者来说，选择相关的框架可能是一个挑战。提供了一个由 CDSS 实施框架解决的领域分类法，以及它们的使用描述，以及按其解决的实施阶段列出的框架目录。未来的工作应确保充分描述 CDSS 设计的最佳实践，并对现有框架进行良好验证。强调临床医生和非临床医生受影响方之间的合作可能有助于推动该领域的发展。
