TY - CHAP M1 - Book, Section TI - Clinical Decision Support Systems A1 - Holbrook, Anne M. A1 - Randolph, Adrienne G. A1 - Brandt, Linn A1 - Garg, Amit X. A1 - Haynes, R. Brian A1 - Cook, Deborah J. A1 - Guyatt, Gordon A2 - Guyatt, Gordon A2 - Rennie, Drummond A2 - Meade, Maureen O. A2 - Cook, Deborah J. PY - 2015 T2 - Users' Guides to the Medical Literature: A Manual for Evidence-Based Clinical Practice, 3rd ed AB - CLINICAL SCENARIOOn the ambulatory care clinic rotation rounds in which you are the senior attending physician, a senior resident comments that nearly half of the patients seen today have diabetes and many of these patients have complications of diabetes, including previous myocardial infarction, stroke, neuropathy, and nephropathy. Some of the patients are only in their third or fourth decade of life. This leads to a discussion of chronic disease and its effect on disability, quality of life, and mortality, as well as evidence for treatments that improve these outcomes. One of the medical students, who previously worked as a software developer, is convinced that computerized decision support for physicians and patients has to be the way to improve diabetes care. A junior resident from a psychology background points out that a complex chronic disease such as diabetes requires not only awareness of interventions that can decrease mortality and morbidity but also considerable patient investment of learning, time, and expense to address all of the components. You remind the group that diabetes management, with its multiple guideline recommendations, could benefit from clinical decision support systems but that one should ask whether the systems improve patient outcomes. The senior resident, intrigued by the discussion, commits to presenting a well-done randomized clinical trial (RCT) that addresses the effect of computerized decision support systems on diabetes management at the upcoming morning report for all house staff and attending physicians. You tell her that there have been so many studies in this area that it might be more efficient to look for a well-done systematic review. SN - PB - McGraw-Hill Education CY - New York, NY Y2 - 2024/03/28 UR - jamaevidence.mhmedical.com/content.aspx?aid=1183876168 ER -