Accepted for/Published in: Journal of Medical Internet Research
Date Submitted: Jul 21, 2023
Date Accepted: Nov 12, 2023
Applications of Clinical Decision Support Systems (CDSSs) in Diabetes Care: A Scoping Review
ABSTRACT
Background:
Providing comprehensive and individualized diabetes care remains a significant challenge in the face of the increasing complexity of diabetes management and a lack of specialized endocrinologists to support diabetes care. Clinical Decision Support Systems (CDSSs) were progressively being used to improve diabetes care, while many healthcare providers (HCPs) lacked awareness and knowledge about CDSSs in diabetes care. A comprehensive analysis of the applications of CDSSs in diabetes care was still lacking.
Objective:
This review aimed to summarize the research landscape, clinical applications as well as the impact on both patients and physicians of CDSSs in diabetes care.
Methods:
We conducted a scoping review following the Arksey and O'Malley framework. A search was conducted in 7 electronic databases to identify clinical applications of CDSSs in diabetes care by June 30, 2022. Additional searches were conducted for conference abstracts in 2021-2022. Two researchers independently performed the screening and data charting process.
Results:
Out of 11,569 retrieved studies, 85 were included for analysis. Research interest is growing in this field, with 53% of the studies published in the last five years. Among 58 studies disclosed the underlying decision-making mechanism, most CDSSs (76%, 44/58) were knowledge-based, while the number of non-knowledge-based systems has been increasing in recent years. Among 81 studies disclosed application scenarios, the majority of CDSSs were used for treatment recommendation (78%, 63/81). For physician user types, primary care physicians (51%, 20/39) were the most common, followed by endocrinologists (38%, 15/39) and non-endocrinology specialists (21%, 8/39). CDSSs significantly improved patients’ blood glucose, blood pressure, and lipid profiles in 71% (45/63), 67% (12/18), and 38% (8/21) of the studies, respectively, with no increase in the risk of hypoglycemia.
Conclusions:
It has been shown that CDSSs are both effective and safe in improving diabetes care, implying that CDSSs could be a potentially reliable assistant in diabetes care, especially for physicians with limited experience and patients with limited access to medical resources.
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