Chairat Pajaree, Niprapan Piangrawee, Hantrakun Nonthakorn, Tantiworawit Adisak, Punnachet Teerachat, Piriyakhuntorn Pokpong, Rattanathammethee Thanawat, Hantrakool Sasinee, Rattarittamrong Ekarat, Norasetthada Lalita, Chai-Adisaksopha Chatree
Division of Hematology, Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, 110 Intawarorot road, Sriphum, Muang, Chiang Mai, 50200, Thailand.
BMC Med Educ. 2025 Mar 30;25(1):460. doi: 10.1186/s12909-025-07014-z.
Anticoagulant prescription and management are crucial steps of management of venous thromboembolism (VTE). The Clinical decision support systems (CDSS) are designed and developed to aid healthcare professionals in making informed decisions.
To develop and assess the efficacy the mobile app-based CDSS for the management of VTE.
A randomized controlled trial was conducted, enrolling participants aged ≥ 20 years who were one of the following categories: medical student, intern, internal medicine resident, or hematology fellow. Participants were randomly assigned to either app-based CDSS (DECIDE-COAG) or control groups. Participants were tasked with prescribing or planning the management of 15 clinical vignettes covering four domains: anticoagulant dosing, perioperative management, management of anticoagulant associated bleeding and diagnosis of VTE. The primary outcome was the mean percentage of accuracy score.
From September 2023 through November 2023, a total of 126 participants were enrolled. The mean percentage of accuracy score was significantly higher (95.6%) in participants using app-based CDSS compared with those in control group (41.3%), a mean difference of 54.5%, 95% CI 49.8-59.2, p < 0.001. The satisfaction mean score was 4.57 ± 0.49 for accessibility, 4.73 ± 0.45 for app stability, 4.94 ± 0.25 for user interface, 4.78 ± 0.42 for simplicity, 4.98 ± 0.13 for assistance in decision-making and 4.90 ± 0.30 for overall satisfaction.
App-based CDSS (DECIDE-COAG) demonstrates a significant improvement in the accuracy of anticoagulant prescriptions and VTE management. Further studies that specifically investigate the clinical benefits of app-based CDSS in real-world clinical practice are warranted.
TCTR20241117004.
抗凝药物的处方和管理是静脉血栓栓塞症（VTE）管理的关键步骤。临床决策支持系统（CDSS）旨在帮助医疗保健专业人员做出明智的决策。
开发并评估基于移动应用程序的CDSS在VTE管理中的疗效。
进行了一项随机对照试验，招募年龄≥20岁的参与者，他们属于以下类别之一：医学生、实习生、内科住院医师或血液学研究员。参与者被随机分配到基于应用程序的CDSS（DECIDE-COAG）组或对照组。参与者的任务是为15个临床病例制定处方或管理计划，这些病例涵盖四个领域：抗凝药物剂量、围手术期管理、抗凝相关出血的管理以及VTE的诊断。主要结局是准确性评分的平均百分比。
从2023年9月至2023年11月，共招募了126名参与者。使用基于应用程序的CDSS的参与者的准确性评分平均百分比（95.6%）显著高于对照组（41.3%），平均差异为54.5%，95%置信区间为49.8-59.2，p<0.001。可及性的满意度平均评分为4.57±0.49，应用程序稳定性为4.73±0.45，用户界面为4.94±0.25，简单性为4.78±0.42，决策辅助为4.98±0.13，总体满意度为4.90±0.30。
基于应用程序的CDSS（DECIDE-COAG）在抗凝处方和VTE管理的准确性方面有显著提高。有必要进行进一步的研究，专门调查基于应用程序的CDSS在实际临床实践中的临床益处。
TCTR20241117004。
