Encyclopedia of Database Systems

2018 Edition
| Editors: Ling Liu, M. Tamer Özsu

Clinical Decision Support

  • Adam Wright
Reference work entry
DOI: https://doi.org/10.1007/978-1-4614-8265-9_382

Synonyms

CDS; Decision support

Definition

Clinical Decision Support systems are computer systems which assist humans in making optimal clinical decisions. While clinical decision support systems are most often designed for clinicians, they can also be developed to assist patients or caregivers. Common examples of clinical decision support systems include drug-drug interaction checks, dose range checking for medication and preventive care reminders.

Historical Background

The first clinical decision support system was described in 1959 by Robert Ledley and Lee Lusted [6] in their paper “Reasoning foundations of medical diagnosis; symbolic logic, probability, and value theory aid our understanding of how physicians reason.” Ledley and Lusted described an analog computer used to sort cards containing a diagnosis and a series of punches which represented symptoms. By selecting the cards which matched the symptoms present in a given case a clinician could develop a possible set of diagnosis.

This is a preview of subscription content, log in to check access.

Recommended Reading

  1. 1.
    Bates DW, Kuperman GJ, Wang S, et al. Ten commandments for effective clinical decision support: making the practice of evidence-based medicine a reality. J Am Med Inform Assoc. 2003;10(6):523–30.CrossRefGoogle Scholar
  2. 2.
    Garg AX, Adhikari NK, McDonald H, et al. Effects of computerized clinical decision support systems on practitioner performance and patient outcomes: a systematic review. JAMA. 2005;293(10):1223–38.CrossRefGoogle Scholar
  3. 3.
    Kawamoto K, Houlihan CA, Balas EA, Lobach DF. Improving clinical practice using clinical decision support systems: a systematic review of trials to identify features critical to success. BMJ. 2005;330(7494):765.CrossRefGoogle Scholar
  4. 4.
    Kawamoto K , Lobach DF. Design, implementation, use, and preliminary evaluation of SEBASTIAN, a standards-based web service for clinical decision support. In: Proceedings of the AMIA Symposium; 2005. p. 380–4.Google Scholar
  5. 5.
    Kuperman GJ, Gardner RM, Pryor TA. HELP: a dynamic hospital information system. New York: Springer; 1991.CrossRefGoogle Scholar
  6. 6.
    Ledley RS, Lusted LB. Reasoning foundations of medical diagnosis; symbolic logic, probability, and value theory aid our understanding of how physicians reason. Science. 1959;130(3366):9–21.CrossRefGoogle Scholar
  7. 7.
    McDonald CJ. Protocol-based computer reminders, the quality of care and the non-perfectability of man. N Engl J Med. 1976;295(24):1351–5.CrossRefGoogle Scholar
  8. 8.
    Miller RA, Pople HE, Myers JD. Internist-1, an experimental computer-based diagnostic consultant for general internal medicine. N Engl J Med. 1982;307(8):468–76.CrossRefGoogle Scholar
  9. 9.
    Osheroff JA, Pifer EA, Sittig DF, Jenders RA, Teich JM. Improving outcomes with clinical decision support: an implementers’ guide. Chicago: HIMSS; 2005.Google Scholar
  10. 10.
    Osheroff JA, Teich JM, Middleton B, Steen EB, Wright A, Detmer DE. A roadmap for national action on clinical decision support. J Am Med Inform Assoc. 2007;14(2):141–5.CrossRefGoogle Scholar
  11. 11.
    Sittig DF, Wright A, Osheroff JA, et al. Grand challenges in clinical decision support. J Biomed Inform. 2007;41(2):387–92.CrossRefGoogle Scholar
  12. 12.
    Shortliffe EH, Davis R, Axline SG, Buchanan BG, Green CC, Cohen SN. Computer-based consultations in clinical therapeutics: explanation and rule acquisition capabilities of the MYCIN system. Comput Biomed Res. 1975;8(4):303–20.CrossRefGoogle Scholar
  13. 13.
    Wright A, Goldberg H, Hongsermeier T, Middleton B. A description and functional taxonomy of rule-based decision support content at a large integrated delivery network. J Am Med Inform Assoc. 2007;14(4):489–96.CrossRefGoogle Scholar
  14. 14.
    Wright A, Sittig DF. SANDS: a service-oriented architecture for clinical decision support in a National Health Information Network. J Biomed Inform. 2008;41(6).  https://doi.org/10.1016/j.jbi.2008.03.001.CrossRefGoogle Scholar
  15. 15.
    Warner HR, Toronto AF, Veasey LG, Stephenson R. A mathematical approach to medical diagnosis. Application to congenital heart disease. JAMA. 1961;177(3):177–83.CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Partners HealthCareBostonUSA

Section editors and affiliations

  • Vipul Kashyap
    • 1
  1. 1.Director, Clinical ProgramsCIGNA HealthcareBloomfieldUSA