TY - JOUR
T1 - The development and implementation of a guideline-based clinical decision support system to improve empirical antibiotic prescribing
AU - Akhloufi, H.
AU - van der Sijs, H.
AU - Melles, D. C.
AU - van der Hoeven, C. P.
AU - Vogel, M.
AU - Mouton, J. W.
AU - Verbon, A.
N1 - Funding Information:
This work was supported by the Netherlands Organization for Health Research and Development (ZonMW) (Grant No. 836021021).
Publisher Copyright: © 2022, The Author(s).
PY - 2022/5/10
Y1 - 2022/5/10
N2 - Background: To describe and evaluate a clinical decision support system (CDSS) for empirical antibiotic therapy using a systematic framework. Methods: A reporting framework for behavior change intervention implementation was used, which includes several domains: development, evaluation and implementation. Within the development domain a description is given of the engagement of stakeholders, a rationale for how the CDSS may influence antibiotic prescribing and a detailed outline of how the system was developed. Within the evaluation domain a technical validation is performed and the interaction between potential users and the CDSS is analyzed. Within the domain of implementation a description is given on how the CDSS was tested in the real world and the strategies that were used for implementation and adoption of the CDSS. Results: Development: a CDSS was developed, with the involvement of stakeholders, to assist empirical antibiotic prescribing by physicians. Evaluation: Technical problems were determined during the validation process and corrected in a new CDSS version. A usability study was performed to assess problems in the system-user interaction. Implementation: In 114 patients the antibiotic advice that was generated by the CDSS was followed. For 54 patients the recommendations were not adhered to. Conclusions: This study describes the development and validation of a CDSS for empirical antibiotic therapy and shows the usefulness of the systematic framework for reporting CDSS interventions. In addition it shows that CDSS recommendations are not always adhered to which is associated with incorrect use of the system.
AB - Background: To describe and evaluate a clinical decision support system (CDSS) for empirical antibiotic therapy using a systematic framework. Methods: A reporting framework for behavior change intervention implementation was used, which includes several domains: development, evaluation and implementation. Within the development domain a description is given of the engagement of stakeholders, a rationale for how the CDSS may influence antibiotic prescribing and a detailed outline of how the system was developed. Within the evaluation domain a technical validation is performed and the interaction between potential users and the CDSS is analyzed. Within the domain of implementation a description is given on how the CDSS was tested in the real world and the strategies that were used for implementation and adoption of the CDSS. Results: Development: a CDSS was developed, with the involvement of stakeholders, to assist empirical antibiotic prescribing by physicians. Evaluation: Technical problems were determined during the validation process and corrected in a new CDSS version. A usability study was performed to assess problems in the system-user interaction. Implementation: In 114 patients the antibiotic advice that was generated by the CDSS was followed. For 54 patients the recommendations were not adhered to. Conclusions: This study describes the development and validation of a CDSS for empirical antibiotic therapy and shows the usefulness of the systematic framework for reporting CDSS interventions. In addition it shows that CDSS recommendations are not always adhered to which is associated with incorrect use of the system.
UR - http://www.scopus.com/inward/record.url?scp=85129768774&partnerID=8YFLogxK
U2 - 10.1186/s12911-022-01860-3
DO - 10.1186/s12911-022-01860-3
M3 - Article
C2 - 35538525
AN - SCOPUS:85129768774
SN - 1472-6947
VL - 22
JO - BMC Medical Informatics and Decision Making
JF - BMC Medical Informatics and Decision Making
IS - 1
M1 - 127
ER -