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Accepted for/Published in: JMIR Diabetes

Date Submitted: Jun 30, 2017
Date Accepted: May 3, 2018
(closed for review but you can still tweet)

The final, peer-reviewed published version of this preprint can be found here:

Models Used in Clinical Decision Support Systems Supporting Healthcare Professionals Treating Chronic Wounds: Systematic Literature Review

Schaarup C, Pape-Haugaard LB, Hejlesen OK

Models Used in Clinical Decision Support Systems Supporting Healthcare Professionals Treating Chronic Wounds: Systematic Literature Review

JMIR Diabetes 2018;3(2):e11

DOI: 10.2196/diabetes.8316

PMID: 30291078

PMCID: 6238865

Models Used in Clinical Decision Support Systems Supporting Healthcare Professionals Treating Chronic Wounds: Systematic Literature Review

  • Clara Schaarup; 
  • Louise Bilenberg Pape-Haugaard; 
  • Ole Kristian Hejlesen

ABSTRACT

Background:

Chronic wounds such as diabetic foot ulcers, venous leg ulcers, and pressure ulcers are a massive burden to health care facilities. Many randomized controlled trials on different wound care elements have been conducted and published in the Cochrane Library, all of which have only a low evidential basis. Thus, health care professionals are forced to rely on their own experience when making decisions regarding wound care. To progress from experience-based practice to evidence-based wound care practice, clinical decision support systems (CDSS) that help health care providers with decision-making in a clinical workflow have been developed. These systems have proven useful in many areas of the health care sector, partly because they have increased the quality of care, and partially because they have generated a solid basis for evidence-based practice. However, no systematic reviews focus on CDSS within the field of wound care to chronic wounds.

Objective:

The aims of this systematic literature review are (1) to identify models used in CDSS that support health care professionals treating chronic wounds, and (2) to classify each clinical decision support model according to selected variables and to create an overview.

Methods:

A systematic review was conducted using 6 databases. This systematic literature review follows the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement for systematic reviews. The search strategy consisted of three facets, respectively: Facet 1 (Algorithm), Facet 2 (Wound care) and Facet 3 (Clinical decision support system). Studies based on acute wounds or trauma were excluded. Similarly, studies that presented guidelines, protocols and instructions were excluded, since they do not require progression along an active chain of reasoning from the clinicians, just their focus. Finally, studies were excluded if they had not undergone a peer review process. The following aspects were extracted from each article: authors, year, country, the sample size of data and variables describing the type of clinical decision support models. The decision support models were classified in 2 ways: quantitative decision support models, and qualitative decision support models.

Results:

The final number of studies included in the systematic literature review was 10. These clinical decision support models included 4/10 (40%) quantitative decision support models and 6/10 (60%) qualitative decision support models. The earliest article was published in 2007, and the most recent was from 2015.

Conclusions:

The clinical decision support models were targeted at a variety of different types of chronic wounds. The degree of accessibility of the inference engines varied. Quantitative models served as the engine and were invisible to the health care professionals, while qualitative models required interaction with the user.


 Citation

Please cite as:

Schaarup C, Pape-Haugaard LB, Hejlesen OK

Models Used in Clinical Decision Support Systems Supporting Healthcare Professionals Treating Chronic Wounds: Systematic Literature Review

JMIR Diabetes 2018;3(2):e11

DOI: 10.2196/diabetes.8316

PMID: 30291078

PMCID: 6238865

Per the author's request the PDF is not available.