BibTex format
@article{Rawson:2017:10.1016/j.cmi.2017.02.028,
author = {Rawson, T and moore, L and Hernandez, B and Charani, E and Castro, Sanchez E and Herrero, P and Hayhoe, B and Hope, W and Georgiou, P and Holmes, A},
doi = {10.1016/j.cmi.2017.02.028},
journal = {Clinical Microbiology and Infection},
pages = {524--532},
title = {A systematic review of clinical decision support systems for antimicrobial management: Are we failing to investigate these interventions appropriately?},
url = {http://dx.doi.org/10.1016/j.cmi.2017.02.028},
volume = {23},
year = {2017}
}
RIS format (EndNote, RefMan)
TY - JOUR
AB - ObjectivesClinical decision support systems (CDSS) for antimicrobial management can support clinicians to optimise antimicrobial therapy. We reviewed all original literature (qualitative and quantitative) to understand the current scope of CDSS for antimicrobial management and analyse existing methods used to evaluate and report such systems. MethodPRISMA guidelines were followed. Medline, EMBASE, HMIC Health and Management, and Global Health databases were searched from 1st January 1980 to 31st October 2015. All primary research studies describing CDSS for antimicrobial management in adults in primary or secondary care were included. For qualitative studies, thematic synthesis was performed. Quality was assessed using Integrated quality Criteria for the Review Of Multiple Study designs (ICROMS) criteria. CDSS reporting was assessed against a reporting framework for behaviour change intervention implementation.ResultsFifty-eight original articles were included describing 38 independent CDSS. The majority of systems target antimicrobial prescribing (29/38;76%), are platforms integrated with electronic medical records (28/38;74%), and have rules based infrastructure providing decision support (29/38;76%). On evaluation against the intervention reporting framework, CDSS studies fail to report consideration of the non-expert, end-user workflow. They have narrow focus, such as antimicrobial selection, and use proxy outcome measures. Engagement with CDSS by clinicians was poor.ConclusionGreater consideration of the factors that drive non-expert decision making must be considered when designing CDSS interventions. Future work must aim to expand CDSS beyond simply selecting appropriate antimicrobials with clear and systematic reporting frameworks for CDSS interventions developed to address current gaps identified in the reporting of evidence.
AU - Rawson,T
AU - moore,L
AU - Hernandez,B
AU - Charani,E
AU - Castro,Sanchez E
AU - Herrero,P
AU - Hayhoe,B
AU - Hope,W
AU - Georgiou,P
AU - Holmes,A
DO - 10.1016/j.cmi.2017.02.028
EP - 532
PY - 2017///
SN - 1469-0691
SP - 524
TI - A systematic review of clinical decision support systems for antimicrobial management: Are we failing to investigate these interventions appropriately?
T2 - Clinical Microbiology and Infection
UR - http://dx.doi.org/10.1016/j.cmi.2017.02.028
UR - http://hdl.handle.net/10044/1/45082
VL - 23
ER -
