Is ED clinical decision support useful? It's complicated, says study

A study in the Journal of the American Medical Informatics Association investigates whether computerized clinical decision support systems can improve emergency care.

The researchers — led by Paula Bennett of the United Kingdom-based Greater Manchester Academic Health Science Network — conducted an international literature review of 23 studies related to the impact of computerized CDS on emergency department patient care.

They found roughly half of the studies demonstrated CDS had a significant positive impact on clinical care. The other half of the studies showed small improvements, particularly related to clinical documentation.

However, the researchers emphasize the methodological quality of the studies was poor, with very few control variables. "The ED environment is complex and does not lend itself to robust quantitative designs such as randomized controlled trials," researchers noted. "The quality of the research in ∼75 percent of the studies was poor, and therefore conclusions cannot be drawn from these results."

The researchers concluded, "further high-quality research is needed to better understand what technological solutions can offer clinicians and patients."

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