Clinical decision support system: an effective pathway to promote shared decision making between clinician and patient.

Tags: Poster
Jia P1, Zhang L1, Zhao P1, Zhang M1
1Chinese Cochrane Center, China

Background: A clinical decision support system (CDSS) has been defined as a computerized system that uses case-based reasoning to assist clinicians in assessing disease status, in making a diagnosis, in selecting appropriate therapy or in making other clinical decisions. Related studies showed that CDSS can promote shared decision making and improve clinical decisions. However, little is known about the ways and factors that are most effective in promoting shared decision making between clinicians and patients.

Objectives: To provide a rigorous, evidence-based assessment of the ways and factors that are most effective in influencing shared decision making between clinicians and patients.

Methods: We searched the MEDLINE, EMBASE, Cochrane Library and four main Chinese databases including CBM, VIP, CNKI and Wanfang using the search term “decision support systems, clinical”, “decision-making, computer assisted”, “CDSS”, “shared decision making”, “shared determinant” etc from 1977 to March 2015. Microsoft Excel 2007 was used to perform data extraction and analysis.

Results: We included a total of 340 studies in our study that ranged from 1997 to 2015. The number of studies reached its peak for 2010, with 56 studies accounting for 17.47% of the years’ publication. The CDSS can promote shared decision making in five major ways: timely alerting (37.5%), transparency interpreting (17.4%),scientific critiquing (8.6%), reasonable assisting (8.0%), diagnosing and managing (6%).Several practical factors contribute to the success of CDSS in promoting shared decision making: 1) automatic provision of decision support; 2) an intuitive user interface; 3) timely decision support; 4) providing actionable recommendations that are succinct and relevant to patient care; and 5) knowledge skill of patient and clinician.

Conclusions: There are a great number of ways and factors that influence the use of CDSS for promoting shared decision making between clinicians and patients. Further research needs to be conducted before there is widespread dissemination into clinical practice.