RT Book, Section
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.
SR Print(0)
ID 1183876168
T1 Clinical Decision Support Systems
T2 Users' Guides to the Medical Literature: A Manual for Evidence-Based Clinical Practice, 3rd ed
YR 2015
FD 2015
PB McGraw-Hill Education
PP New York, NY
SN 978-0-07-179071-0
LK jamaevidence.mhmedical.com/content.aspx?aid=1183876168
RD 2024/04/18
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.