CDSS-RM: a clinical decision support system reference model.

Abstract:

:Clinical Decision Support Systems (CDSS) provide aid in clinical decision making and therefore need to take into consideration human, data interactions, and cognitive functions of clinical decision makers. The objective of this paper is to introduce a high level reference model that is intended to be used as a foundation to design successful and contextually relevant CDSS systems. The paper begins by introducing the information flow, use, and sharing characteristics in a hospital setting, and then it outlines the referential context for the model, which are clinical decisions in a hospital setting. Important characteristics of the Clinical decision making process include: (i) Temporally ordered steps, each leading to new data, which in turn becomes useful for a new decision, (ii) Feedback loops where acquisition of new data improves certainty and generates new questions to examine, (iii) Combining different kinds of clinical data for decision making, (iv) Reusing the same data in two or more different decisions, and (v) Clinical decisions requiring human cognitive skills and knowledge, to process the available information. These characteristics form the foundation to delineate important considerations of Clinical Decision Support Systems design. The model includes six interacting and interconnected elements, which formulate the high-level reference model (CDSS-RM). These elements are introduced in the form of questions, as considerations, and are examined with the use of illustrated scenario-based and data-driven examples. The six elements /considerations of the reference model are: (i) Do CDSS mimic the cognitive process of clinical decision makers? (ii) Do CDSS provide recommendations with longitudinal insight? (iii) Is the model performance contextually realistic? (iv) Is the 'Historical Decision' bias taken into consideration in CDSS design? (v) Do CDSS integrate established clinical standards and protocols? (vi) Do CDSS utilize unstructured data? The CDSS-RM reference model can contribute to optimized design of modeling methodologies, in order to improve response of health systems to clinical decision-making challenges.

journal_name

BMC Med Res Methodol

authors

Zikos D,DeLellis N

doi

10.1186/s12874-018-0587-6

subject

Has Abstract

pub_date

2018-11-16 00:00:00

pages

137

issue

1

issn

1471-2288

pii

10.1186/s12874-018-0587-6

journal_volume

18

pub_type

杂志文章
  • Translation method is validity evidence for construct equivalence: analysis of secondary data routinely collected during translations of the Health Literacy Questionnaire (HLQ).

    abstract:BACKGROUND:Cross-cultural research with patient-reported outcomes measures (PROMs) assumes that the PROM in the target language will measure the same construct in the same way as the PROM in the source language. Yet translation methods are rarely used to qualitatively maximise construct equivalence or to describe the i...

    journal_title:BMC medical research methodology

    pub_type: 杂志文章

    doi:10.1186/s12874-020-00962-8

    authors: Hawkins M,Cheng C,Elsworth GR,Osborne RH

    更新日期:2020-05-26 00:00:00

  • Outcome-sensitive multiple imputation: a simulation study.

    abstract:BACKGROUND:Multiple imputation is frequently used to deal with missing data in healthcare research. Although it is known that the outcome should be included in the imputation model when imputing missing covariate values, it is not known whether it should be imputed. Similarly no clear recommendations exist on: the util...

    journal_title:BMC medical research methodology

    pub_type: 杂志文章

    doi:10.1186/s12874-016-0281-5

    authors: Kontopantelis E,White IR,Sperrin M,Buchan I

    更新日期:2017-01-09 00:00:00

  • Pragmatic controlled clinical trials in primary care: the struggle between external and internal validity.

    abstract:BACKGROUND:Controlled clinical trials of health care interventions are either explanatory or pragmatic. Explanatory trials test whether an intervention is efficacious; that is, whether it can have a beneficial effect in an ideal situation. Pragmatic trials measure effectiveness; they measure the degree of beneficial ef...

    journal_title:BMC medical research methodology

    pub_type: 杂志文章

    doi:10.1186/1471-2288-3-28

    authors: Godwin M,Ruhland L,Casson I,MacDonald S,Delva D,Birtwhistle R,Lam M,Seguin R

    更新日期:2003-12-22 00:00:00

  • Randomised controlled comparison of the Health Survey Short Form (SF-12) and the Graded Chronic Pain Scale (GCPS) in telephone interviews versus self-administered questionnaires. Are the results equivalent?

    abstract:BACKGROUND:The most commonly used survey methods are self-administered questionnaires, telephone interviews, and a mixture of both. But until now evidence out of randomised controlled trials as to whether patient responses differ depending on the survey mode is lacking. Therefore this study assessed whether patient res...

    journal_title:BMC medical research methodology

    pub_type: 杂志文章,随机对照试验

    doi:10.1186/1471-2288-7-50

    authors: Lungenhausen M,Lange S,Maier C,Schaub C,Trampisch HJ,Endres HG

    更新日期:2007-11-22 00:00:00

  • Participant recruitment in sensitive surveys: a comparative trial of 'opt in' versus 'opt out' approaches.

    abstract:BACKGROUND:Although in health services survey research we strive for a high response rate, this must be balanced against the need to recruit participants ethically and considerately, particularly in surveys with a sensitive nature. In survey research there are no established recommendations to guide recruitment approac...

    journal_title:BMC medical research methodology

    pub_type: 临床试验,杂志文章

    doi:10.1186/1471-2288-13-3

    authors: Hunt KJ,Shlomo N,Addington-Hall J

    更新日期:2013-01-11 00:00:00

  • Error in statistical tests of error in statistical tests.

    abstract:BACKGROUND:A recent paper found that terminal digits of statistical values in Nature deviated significantly from an equiprobable distribution, indicating errors or inconsistencies in rounding. This finding, as well as the discovery that a large percentage of p values were inconsistent with reported test statistics, led...

    journal_title:BMC medical research methodology

    pub_type: 评论,杂志文章

    doi:10.1186/1471-2288-6-45

    authors: Jeng M

    更新日期:2006-09-13 00:00:00

  • Enhanced reporting of deaths among Aboriginal and Torres Strait Islander peoples using linked administrative health datasets.

    abstract:BACKGROUND:Aboriginal and Torres Strait Islander peoples are under-reported in administrative health datasets in NSW, Australia. Correct reporting of Aboriginal and Torres Strait Islander peoples is essential to measure the effectiveness of policies and programmes aimed at reducing the health disadvantage experienced b...

    journal_title:BMC medical research methodology

    pub_type: 杂志文章

    doi:10.1186/1471-2288-12-91

    authors: Taylor LK,Bentley J,Hunt J,Madden R,McKeown S,Brandt P,Baker D

    更新日期:2012-07-02 00:00:00

  • Should we embed randomized controlled trials within action research: arguing from a case study of telemonitoring.

    abstract:BACKGROUND:Action research (AR) and randomized controlled trials (RCTs) are usually considered to be theoretically and practically incompatible. However, we argue that their respective strengths and weaknesses can be complementary. We illustrate our argument from a recent study assessing the effect of telemonitoring on...

    journal_title:BMC medical research methodology

    pub_type: 杂志文章,随机对照试验

    doi:10.1186/s12874-016-0175-6

    authors: Day K,Kenealy TW,Sheridan NF

    更新日期:2016-06-08 00:00:00

  • Structure formats of randomised controlled trial abstracts: a cross-sectional analysis of their current usage and association with methodology reporting.

    abstract:BACKGROUND:The reporting of randomised controlled trial (RCT) abstracts is of vital importance. The primary objective of this study was to investigate the association between structure format and RCT abstracts' quality of methodology reporting, informed by the current requirement and usage of structure formats by leadi...

    journal_title:BMC medical research methodology

    pub_type: 杂志文章

    doi:10.1186/s12874-017-0469-3

    authors: Hua F,Walsh T,Glenny AM,Worthington H

    更新日期:2018-01-10 00:00:00

  • Using a social marketing framework to evaluate recruitment of a prospective study of genetic counseling and testing for the deaf community.

    abstract:BACKGROUND:Recruiting deaf and hard-of-hearing participants, particularly sign language-users, for genetics health service research is challenging due to communication barriers, mistrust toward genetics, and researchers' unfamiliarity with deaf people. Feelings of social exclusion and lack of social cohesion between re...

    journal_title:BMC medical research methodology

    pub_type: 杂志文章

    doi:10.1186/1471-2288-13-145

    authors: Kobayashi Y,Boudreault P,Hill K,Sinsheimer JS,Palmer CG

    更新日期:2013-11-25 00:00:00

  • Applying an intersectionality lens to the theoretical domains framework: a tool for thinking about how intersecting social identities and structures of power influence behaviour.

    abstract:BACKGROUND:A key component of the implementation process is identifying potential barriers and facilitators that need to be addressed. The Theoretical Domains Framework (TDF) is one of the most commonly used frameworks for this purpose. When applying the TDF, it is critical to understand the context in which behaviours...

    journal_title:BMC medical research methodology

    pub_type: 杂志文章

    doi:10.1186/s12874-020-01056-1

    authors: Etherington N,Rodrigues IB,Giangregorio L,Graham ID,Hoens AM,Kasperavicius D,Kelly C,Moore JE,Ponzano M,Presseau J,Sibley KM,Straus S

    更新日期:2020-06-26 00:00:00

  • Correction for retest effects across repeated measures of cognitive functioning: a longitudinal cohort study of postoperative delirium.

    abstract:BACKGROUND:Few studies have compared methods to correct for retest effects or practice effects in settings where an acute event could influence test performance, such as major surgery. Our goal in this study was to evaluate the use of different methods to correct for the effects of practice or retest on repeated test a...

    journal_title:BMC medical research methodology

    pub_type: 杂志文章

    doi:10.1186/s12874-018-0530-x

    authors: Racine AM,Gou Y,Fong TG,Marcantonio ER,Schmitt EM,Travison TG,Inouye SK,Jones RN

    更新日期:2018-07-03 00:00:00

  • Heckman-type selection models to obtain unbiased estimates with missing measures outcome: theoretical considerations and an application to missing birth weight data.

    abstract:BACKGROUND:In low-income settings, key outcomes such as biomarkers or clinical assessments are often missing for a substantial proportion of the study population. The aim of this study was to assess the extent to which Heckman-type selection models can create unbiased estimates in such settings. METHODS:We introduce t...

    journal_title:BMC medical research methodology

    pub_type: 杂志文章

    doi:10.1186/s12874-019-0840-7

    authors: Koné S,Bonfoh B,Dao D,Koné I,Fink G

    更新日期:2019-12-09 00:00:00

  • An evaluation of DistillerSR's machine learning-based prioritization tool for title/abstract screening - impact on reviewer-relevant outcomes.

    abstract:BACKGROUND:Systematic reviews often require substantial resources, partially due to the large number of records identified during searching. Although artificial intelligence may not be ready to fully replace human reviewers, it may accelerate and reduce the screening burden. Using DistillerSR (May 2020 release), we eva...

    journal_title:BMC medical research methodology

    pub_type: 杂志文章

    doi:10.1186/s12874-020-01129-1

    authors: Hamel C,Kelly SE,Thavorn K,Rice DB,Wells GA,Hutton B

    更新日期:2020-10-15 00:00:00

  • Bayesian methods in clinical trials: a Bayesian analysis of ECOG trials E1684 and E1690.

    abstract:BACKGROUND:E1684 was the pivotal adjuvant melanoma trial for establishment of high-dose interferon (IFN) as effective therapy of high-risk melanoma patients. E1690 was an intriguing effort to corroborate E1684, and the differences between the outcomes of these trials have embroiled the field in controversy over the pas...

    journal_title:BMC medical research methodology

    pub_type: 杂志文章

    doi:10.1186/1471-2288-12-183

    authors: Ibrahim JG,Chen MH,Chu H

    更新日期:2012-11-29 00:00:00

  • Power and sample size determination for the group comparison of patient-reported outcomes using the Rasch model: impact of a misspecification of the parameters.

    abstract:BACKGROUND:Patient-reported outcomes (PRO) are important as endpoints in clinical trials and epidemiological studies. Guidelines for the development of PRO instruments and analysis of PRO data have emphasized the need to report methods used for sample size planning. The Raschpower procedure has been proposed for sample...

    journal_title:BMC medical research methodology

    pub_type: 杂志文章

    doi:10.1186/s12874-015-0011-4

    authors: Blanchin M,Guilleux A,Perrot B,Bonnaud-Antignac A,Hardouin JB,Sébille V

    更新日期:2015-03-15 00:00:00

  • Data enhancement for co-morbidity measurement among patients referred for sleep diagnostic testing: an observational study.

    abstract:BACKGROUND:Observational outcome studies of patients with obstructive sleep apnea (OSA) require adjustment for co-morbidity to produce valid results. The aim of this study was to evaluate whether the combination of administrative data and self-reported data provided a more complete estimate of co-morbidity among patien...

    journal_title:BMC medical research methodology

    pub_type: 杂志文章

    doi:10.1186/1471-2288-9-50

    authors: Ronksley PE,Tsai WH,Quan H,Faris P,Hemmelgarn BR

    更新日期:2009-07-15 00:00:00

  • Measurement and control of bias in patient reported outcomes using multidimensional item response theory.

    abstract:BACKGROUND:Patient-reported outcome (PRO) measures play a key role in the advancement of patient-centered care research. The accuracy of inferences, relevance of predictions, and the true nature of the associations made with PRO data depend on the validity of these measures. Errors inherent to self-report measures can ...

    journal_title:BMC medical research methodology

    pub_type: 杂志文章

    doi:10.1186/s12874-016-0161-z

    authors: Dowling NM,Bolt DM,Deng S,Li C

    更新日期:2016-05-26 00:00:00

  • Positive predictive value of a case definition for diabetes mellitus using automated administrative health data in children and youth exposed to antipsychotic drugs or control medications: a Tennessee Medicaid study.

    abstract:BACKGROUND:We developed and validated an automated database case definition for diabetes in children and youth to facilitate pharmacoepidemiologic investigations of medications and the risk of diabetes. METHODS:The present study was part of an in-progress retrospective cohort study of antipsychotics and diabetes in Te...

    journal_title:BMC medical research methodology

    pub_type: 杂志文章

    doi:10.1186/1471-2288-12-128

    authors: Bobo WV,Cooper WO,Stein CM,Olfson M,Mounsey J,Daugherty J,Ray WA

    更新日期:2012-08-24 00:00:00

  • Comparison of retention in observational cohorts and nested simulated HIV vaccine efficacy trials in the key populations in Uganda.

    abstract:BACKGROUND:Outcomes in observational studies may not best estimate those expected in the HIV vaccine efficacy trials. We compared retention in Simulated HIV Vaccine Efficacy Trials (SiVETs) and observational cohorts drawn from two key populations in Uganda. METHODS:Two SiVETs were nested within two observational cohor...

    journal_title:BMC medical research methodology

    pub_type: 杂志文章

    doi:10.1186/s12874-020-00920-4

    authors: Abaasa A,Todd J,Nash S,Mayanja Y,Kaleebu P,Fast PE,Price M

    更新日期:2020-02-12 00:00:00

  • Variable selection in social-environmental data: sparse regression and tree ensemble machine learning approaches.

    abstract:BACKGROUND:Social-environmental data obtained from the US Census is an important resource for understanding health disparities, but rarely is the full dataset utilized for analysis. A barrier to incorporating the full data is a lack of solid recommendations for variable selection, with researchers often hand-selecting ...

    journal_title:BMC medical research methodology

    pub_type: 杂志文章

    doi:10.1186/s12874-020-01183-9

    authors: Handorf E,Yin Y,Slifker M,Lynch S

    更新日期:2020-12-10 00:00:00

  • Accounting for misclassification bias of binary outcomes due to underscreening: a sensitivity analysis.

    abstract:BACKGROUND:Diagnostic tests are performed in a subset of the population who are at higher risk, resulting in undiagnosed cases among those who do not receive the test. This poses a challenge for estimating the prevalence of the disease in the study population, and also for studying the risk factors for the disease. ME...

    journal_title:BMC medical research methodology

    pub_type: 杂志文章

    doi:10.1186/s12874-017-0447-9

    authors: Zhang N,Cheng S,Ambroggio L,Florin TA,Macaluso M

    更新日期:2017-12-12 00:00:00

  • A random effects variance shift model for detecting and accommodating outliers in meta-analysis.

    abstract:BACKGROUND:Meta-analysis typically involves combining the estimates from independent studies in order to estimate a parameter of interest across a population of studies. However, outliers often occur even under the random effects model. The presence of such outliers could substantially alter the conclusions in a meta-a...

    journal_title:BMC medical research methodology

    pub_type: 杂志文章

    doi:10.1186/1471-2288-11-19

    authors: Gumedze FN,Jackson D

    更新日期:2011-02-16 00:00:00

  • National weighting of data from the Behavioral Risk Factor Surveillance System (BRFSS).

    abstract:BACKGROUND:The Behavioral Risk Factor Surveillance System (BRFSS) is a network of health-related telephone surveys--conducted by all 50 states, the District of Columbia, and participating US territories-that receive technical assistance from CDC. Data users often aggregate BRFSS state samples for national estimates wit...

    journal_title:BMC medical research methodology

    pub_type: 杂志文章

    doi:10.1186/s12874-016-0255-7

    authors: Iachan R,Pierannunzi C,Healey K,Greenlund KJ,Town M

    更新日期:2016-11-15 00:00:00

  • Comparison of sample characteristics in two pregnancy cohorts: community-based versus population-based recruitment methods.

    abstract:BACKGROUND:One of the biggest challenges for population health studies is the recruitment of participants. Questions that investigators have asked are "who volunteers for studies?" and "does recruitment method influence characteristics of the samples?" The purpose of this paper was to compare sample characteristics of ...

    journal_title:BMC medical research methodology

    pub_type: 杂志文章

    doi:10.1186/1471-2288-13-149

    authors: Leung BM,McDonald SW,Kaplan BJ,Giesbrecht GF,Tough SC

    更新日期:2013-12-06 00:00:00

  • Assembling and validating a heart failure-free cohort from the Reasons for Geographic and Racial Differences in Stroke (REGARDS) study.

    abstract:BACKGROUND:Studies examining incident heart failure (HF) have been limited to select populations. To examine incident HF with broader generalizability, there is need to assemble a HF-free cohort using a geographically-diverse sample. We aimed to develop and validate a simple medication-based strategy for assembling a H...

    journal_title:BMC medical research methodology

    pub_type: 杂志文章

    doi:10.1186/s12874-019-0890-x

    authors: Goyal P,Mefford MT,Chen L,Sterling MR,Durant RW,Safford MM,Levitan EB

    更新日期:2020-03-04 00:00:00

  • Recruiting former melanoma patients via hospitals in comparison to office-based dermatologists in a register-based cohort study that required indirect contact.

    abstract:BACKGROUND:There are detailed reviews about different recruitment strategies, but not with regard to differences between recruitment of hospital-based versus office-based physicians. Within this study, the two different recruitment schemes are compared. Advantages and disadvantages of different ways of recruitment in r...

    journal_title:BMC medical research methodology

    pub_type: 杂志文章

    doi:10.1186/s12874-017-0425-2

    authors: Zeissig SR,Weyer-Elberich V,Emrich K,Binder H,Fischbeck S,Imruck BH,Friedrich-Mai P,Beutel ME,Blettner M

    更新日期:2017-11-22 00:00:00

  • Network-meta analysis made easy: detection of inconsistency using factorial analysis-of-variance models.

    abstract:BACKGROUND:Network meta-analysis can be used to combine results from several randomized trials involving more than two treatments. Potential inconsistency among different types of trial (designs) differing in the set of treatments tested is a major challenge, and application of procedures for detecting and locating inc...

    journal_title:BMC medical research methodology

    pub_type: 杂志文章

    doi:10.1186/1471-2288-14-61

    authors: Piepho HP

    更新日期:2014-05-10 00:00:00

  • Adaptive propensity score procedure improves matching in prospective observational trials.

    abstract:BACKGROUND:Randomized controlled trials are the gold-standard for clinical trials. However, randomization is not always feasible. In this article we propose a prospective and adaptive matched case-control trial design assuming that a control group already exists. METHODS:We propose and discuss an interim analysis step...

    journal_title:BMC medical research methodology

    pub_type: 杂志文章

    doi:10.1186/s12874-019-0763-3

    authors: Weber D,Uhlmann L,Schönenberger S,Kieser M

    更新日期:2019-07-16 00:00:00

  • Automated inter-rater reliability assessment and electronic data collection in a multi-center breast cancer study.

    abstract:BACKGROUND:The choice between paper data collection methods and electronic data collection (EDC) methods has become a key question for clinical researchers. There remains a need to examine potential benefits, efficiencies, and innovations associated with an EDC system in a multi-center medical record review study. MET...

    journal_title:BMC medical research methodology

    pub_type: 杂志文章,多中心研究

    doi:10.1186/1471-2288-7-23

    authors: Thwin SS,Clough-Gorr KM,McCarty MC,Lash TL,Alford SH,Buist DS,Enger SM,Field TS,Frost F,Wei F,Silliman RA

    更新日期:2007-06-18 00:00:00