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Author Notes:

Address correspondence to: David P. Hopkins MD, MPH, Community Guide Branch, Division of Epidemiology, Analysis, and Library Services, Center for Surveillance, Epidemiology, and Laboratory Services, CDC, 1600 Clifton Road, Mailstop E-69, Atlanta GA 30329. dhh4@cdc.gov.

The authors acknowledge Michael Schooley and the Division for Heart Disease and Stroke Prevention, CDC, for their support at every step of the review. Gillian Sanders (Duke Evidence-Based Practice Center), Lynne T. Braun (Rush University College of Nursing), and Ninad Mishra (National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, CDC) provided guidance during the initial conceptualization. Randy Elder, Kate W. Harris, Kristen Folsom, and Onnalee Gomez (all from the Community Guide Branch, CDC) provided input at various stages of the review and the development of the manuscript.

With great sadness, the authors note the untimely passing of David B. Callahan earlier this year. We greatly valued his insight and contribution to this review.

Points of view are those of the authors and the Community Preventive Services Task Force and do not necessarily represent those of CDC.

Subjects:

Research Funding:

The work of Gibril Njie and Ramona Finnie was supported with funds from the Oak Ridge Institute for Scientific Education.

Keywords:

  • Science & Technology
  • Life Sciences & Biomedicine
  • Public, Environmental & Occupational Health
  • General & Internal Medicine
  • RANDOMIZED-CONTROLLED-TRIAL
  • HEALTH INFORMATION-TECHNOLOGY
  • COMPUTER-GENERATED PHYSICIAN
  • PRIMARY-CARE PRACTICE
  • QUALITY-OF-CARE
  • BLOOD-PRESSURE
  • DIABETES CARE
  • PRESCRIBING BEHAVIOR
  • LIPID MANAGEMENT
  • TASK DELEGATION

Clinical Decision Support Systems and Prevention: A Community Guide Cardiovascular Disease Systematic Review

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Journal Title:

American Journal of Preventive Medicine

Volume:

Volume 49, Number 5

Publisher:

, Pages 784-795

Type of Work:

Article | Post-print: After Peer Review

Abstract:

Context: Clinical decision support systems (CDSSs) can help clinicians assess cardiovascular disease (CVD) risk and manage CVD risk factors by providing tailored assessments and treatment recommendations based on individual patient data. The goal of this systematic review was to examine the effectiveness of CDSSs in improving screening for CVD risk factors, practices for CVD-related preventive care services such as clinical tests and prescribed treatments, and management of CVD risk factors. Evidence acquisition: An existing systematic review (search period, January 1975-January 2011) of CDSSs for any condition was initially identified. Studies of CDSSs that focused on CVD prevention in that review were combined with studies identified through an updated search (January 2011-October 2012). Data analysis was conducted in 2013. Evidence synthesis: A total of 45 studies qualified for inclusion in the review. Improvements were seen for recommended screening and other preventive care services completed by clinicians, recommended clinical tests completed by clinicians, and recommended treatments prescribed by clinicians (median increases of 3.8, 4.0, and 2.0 percentage points, respectively). Results were inconsistent for changes in CVD risk factors such as systolic and diastolic blood pressure, total and low-density lipoprotein cholesterol, and hemoglobin A1C levels. Conclusions: CDSSs are effective in improving clinician practices related to screening and other preventive care services, clinical tests, and treatments. However, more evidence is needed from implementation of CDSSs within the broad context of comprehensive service delivery aimed at reducing CVD risk and CVD-related morbidity and mortality.

Copyright information:

This is an Open Access work distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License (http://creativecommons.org/licenses/by-nc-nd/4.0/).

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