학술논문

Clinical Decision Support System Used in Spinal Disorders: Scoping Review
Document Type
Academic Journal
Source
Journal of Medical Internet Research. March 19, 2024, Vol. 26 Issue 6
Subject
Medical research -- Health aspects
Medicine, Experimental -- Health aspects
Decision-making -- Health aspects
Pain -- Care and treatment
Knowledge-based systems -- Health aspects
Backache -- Development and progression
Health
Knowledge-based system
Development and progression
Health aspects
Language
English
ISSN
1439-4456
Abstract
Background Spinal disorders are highly prevalent worldwide with high socioeconomic costs. This cost is associated with the demand for treatment and productivity loss, prompting the exploration of technologies to improve patient outcomes. Clinical decision support systems (CDSSs) are computerized systems that are increasingly used to facilitate safe and efficient health care. Their applications range in depth and can be found across health care specialties. Objective This scoping review aims to explore the use of CDSSs in patients with spinal disorders. Methods We used the Joanna Briggs Institute methodological guidance for this scoping review and reported according to the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews) statement. Databases, including PubMed, Embase, Cochrane, CINAHL, Web of Science, Scopus, ProQuest, and PsycINFO, were searched from inception until October 11, 2022. The included studies examined the use of digitalized CDSSs in patients with spinal disorders. Results A total of 4 major CDSS functions were identified from 31 studies: preventing unnecessary imaging (n=8, 26%), aiding diagnosis (n=6, 19%), aiding prognosis (n=11, 35%), and recommending treatment options (n=6, 20%). Most studies used the knowledge-based system. Logistic regression was the most commonly used method, followed by decision tree algorithms. The use of CDSSs to aid in the management of spinal disorders was generally accepted over the threat to physicians’ clinical decision-making autonomy. Conclusions Although the effectiveness was frequently evaluated by examining the agreement between the decisions made by the CDSSs and the health care providers, comparing the CDSS recommendations with actual clinical outcomes would be preferable. In addition, future studies on CDSS development should focus on system integration, considering end user’s needs and preferences, and external validation and impact studies to assess effectiveness and generalizability. Trial Registration OSF Registries osf.io/dyz3f; https://osf.io/dyz3f
Introduction Background Spinal diseases are a group of conditions that affect the spinal column, leading to various symptoms ranging from pain to paralysis. The types of conditions may include spinal [...]