What are the 10 most cited CDSS articles?

by Daniel J. Power
Editor, DSSResources.COM

Google Scholar was searched using the search term "clinical decision support systems." Garg et. al (2005) was the most frequently cited with 2942 citations. They concluded "Many CDSSs improve practitioner performance. To date, the effects on patient outcomes remain understudied and, when studied, inconsistent". They examined 100 studies that met their inclusion criteria. The studies included "randomized and nonrandomized controlled trials that evaluated the effect of a CDSS compared with care provided without a CDSS on practitioner performance or patient outcomes."

The next most frequently cited article by Kawamoto, et al. (2005), has had 2189 citations. The researchers "wanted to identify features of clinical decision support systems critical for improving clinical practice". Seventy studies were included in the review. Decision support systems significantly improved clinical practice in 68% of trials. Four features were "independent predictors of improved clinical practice: automatic provision of decision support as part of clinician workflow (P < 0.00001), provision of recommendations rather than just assessments (P = 0.0187), provision of decision support at the time and location of decision making (P = 0.0263), and computer-based decision support (P = 0.0294). Of 32 systems possessing all four features, 30 (94%) significantly improved clinical practice."

Hunt et al (1998), cited by 1880 articles, concluded that "CDSSs can enhance clinical performance for drug dosing, preventive care, and other aspects of medical care, but not convincingly for diagnosis. The effects of CDSSs on patient outcomes have been insufficiently studied.

Effects of computerized physician order entry and clinical decision support systems on medication safety: a systematic review R Kaushal, KG Shojania, DW Bates - Archives of internal …, 2003 - Background Iatrogenic injuries related to medications are common, costly, and clinically significant. Computerized physician order entry (CPOE) and clinical decision support systems (CDSSs) may reduce medication error rates. Methods We identified trials that … Cited by 1433 Related articles All 15 versions

Ten commandments for effective clinical decision support: making the practice of evidence-based medicine a reality DW Bates, GJ Kuperman, S Wang… - Journal of the …, 2003 - … Article Navigation. Ten Commandments for Effective Clinical Decision Support: Making the Practice of Evidence-based Medicine a Reality. David W. Bates, MD, MSc. Cited by 1134 Related articles All 17 versions

Effects of computer-based clinical decision support systems on clinician performance and patient outcome: a critical appraisal of research ME Johnston, KB Langton, RB Haynes… - Annals of internal …, 1994 - Am Coll Physicians Objective: To review the evidence from controlled trials of the effects of computer-based clinical decision support systems (CDSSs) on clinician performance and patient outcomes. Data Sources: The literature in the MEDLARS, EMBASE, SCISEARCH, and INSPEC … Cited by 905 Related articles All 11 versions [PDF]

Medication-related clinical decision support in computerized provider order entry systems: a review GJ Kuperman, A Bobb, TH Payne… - Journal of the …, 2007 - While medications can improve patients' health, the process of prescribing them is complex and error prone, and medication errors cause many preventable injuries. Computer provider order entry (CPOE) with clinical decision support (CDS), can improve patient safety and … Cited by 685 Related articles All 14 version

Clinical decision support systems for the practice of evidence-based medicine I Sim, P Gorman, RA Greenes… - Journal of the …, 2001 - Background: The use of clinical decision support systems to facilitate the practice of evidence-based medicine promises to substantially improve health care quality. Objective: To describe, on the basis of the proceedings of the Evidence and Decision Support track at … Cited by 591 Related articles All 12 versions [PDF]

Clinical decision-support systems MA Musen, B Middleton, RA Greenes - Biomedical informatics, 2014 - Springer These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves … We are grateful to the co-authors of the chapter on this subject that appeared in the previous edition of this text … Cited by 505 Related articles All 8 versions [PDF]

Effect of clinical decision-support systems: a systematic review TJ Bright, A Wong, R Dhurjati, E Bristow… - Annals of internal …, 2012 - Am Coll Physicians Background: Despite increasing emphasis on the role of clinical decision-support systems (CDSSs) for improving care and reducing costs, evidence to support widespread use is lacking. Purpose: To evaluate the effect of CDSSs on clinical outcomes, health care … Cited by 577 Related articles All 13 versions [PDF]

Evaluating informatics applications—clinical decision support systems literature review B Kaplan - International journal of medical informatics, 2001 - Elsevier This paper reviews clinical decision support systems (CDSS) literature, with a focus on evaluation. The literature indicates a general consensus that clinical decision support systems are thought to have the potential to improve care. Evidence is more equivocal for … Cited by 400 Related articles All 8 versions


Garg, A. X., K. J. N. Adhikari, H. McDonald, M. P. Rosas-Arellano, P. J. Devereaux, J. Beyene, J. Sam, and R. B.Haynes, "Effects of computerized clinical decision support systems on practitioner performance and patient outcomes: a systematic review," JAMA, 2005, at URL

Hunt, D. L., R. B. Haynes, S. E. Hanna, and K. Smith, "Effects of computer-based clinical decision support systems on physician performance and patient outcomes: a systematic review," JAMA, 1998, 280(15):1339-1346 (doi:10.1001/jama.280.15.1339)

Kawamoto, K., C. A. Houlihan, E. A. Balas, and D. F. Lobach, "Improving clinical practice using clinical decision support systems: a systematic review of trials to identify features critical to success," BMJ, 2005, Apr 2; 330(7494): 765, at URL and doi: 10.1136/bmj.38398.500764.8F

Last update: 2019-07-18 12:22
Author: Daniel Power

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