Effect of clinical decision support systems on clinical outcome for acute kidney injury: a systematic review and meta-analysis.
BMC Nephrol
; 22(1): 271, 2021 08 04.
Article
em En
| MEDLINE
| ID: mdl-34348688
ABSTRACT
BACKGROUND:
Clinical decision support systems including both electronic alerts and care bundles have been developed for hospitalized patients with acute kidney injury.METHODS:
Electronic databases were searched for randomized, before-after and cohort studies that implemented a clinical decision support system for hospitalized patients with acute kidney injury between 1990 and 2019. The studies must describe their impact on care processes, patient-related outcomes, or hospital length of stay. The clinical decision support system included both electronic alerts and care bundles.RESULTS:
We identified seven studies involving 32,846 participants. Clinical decision support system implementation significantly reduced mortality (OR 0.86; 95 % CI, 0.75-0.99; p = 0.040, I2 = 65.3 %; n = 5 studies; N = 30,791 participants) and increased the proportion of acute kidney injury recognition (OR 3.12; 95 % CI, 2.37-4.10; p < 0.001, I2 = 77.1 %; n = 2 studies; N = 25,121 participants), and investigations (OR 3.07; 95 % CI, 2.91-3.24; p < 0.001, I2 = 0.0 %; n = 2 studies; N = 25,121 participants).CONCLUSIONS:
Nonrandomized controlled trials of clinical decision support systems for acute kidney injury have yielded evidence of improved patient-centered outcomes and care processes. This review is limited by the low number of randomized trials and the relatively short follow-up period.Palavras-chave
Texto completo:
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Base de dados:
MEDLINE
Assunto principal:
Sistemas de Apoio a Decisões Clínicas
/
Injúria Renal Aguda
Idioma:
En
Ano de publicação:
2021
Tipo de documento:
Article