JMIR Publications

ABSTRACT

Background:

Spinal disorders are highly prevalent worldwide with high socio-economical costs. This cost is associated with the demand for treatment and productivity loss, prompting the exploration of technology to improve patient outcomes. Clinical decision support systems (CDSSs) are computerised systems that are increasingly used to facilitate safe and efficient healthcare. Its application ranges in depth and can be found across healthcare specialities.

Objective:

This review aimed to explore the use of CDSSs for patients with spinal disorders.

Methods:

We used the Joanna Briggs Institute methodological guidance for scoping review and reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis Extension for Scoping Reviews. Included studies examined the use of digitalised CDSSs for patients with spinal disorders.

Results:

Four major CDSS functions were identified from 31 studies: preventing unnecessary imaging (n = 8), diagnosis (n = 6), prognosis (n = 11), and treatment recommendation (n = 6). Most studies utilised the knowledge-based system. Logistic regression was the most employed method followed by decision tree algorithms. The use of CDSSs to aid in the management of spinal disorders was generally accepted over feelings of threat to physicians' clinical decision-making autonomy.

Conclusions:

Although effectiveness was frequently evaluated by examining the agreement between CDSS and healthcare providers' decisions, a preferable comparison would be to compare the CDSS recommendations with actual clinical outcomes. Additionally, future studies on CDSS development should focus on system integration, considering end-user’s needs and preferences, as well as external validation and impact studies, to assess effectiveness and generalisability.