Abstract
Background: To deal with complexity in cancer care, computerized clinical decision support systems (CDSSs) are developed to support quality of care and improve decision-making. We performed a systematic review to explore the value of CDSSs using automated clinical guidelines, Artificial Intelligence, datamining or statistical methods (higher level CDSSs) on the quality of care in oncology. Materials and Methods: The search strategy combined synonyms for ‘CDSS’ and ‘cancer.’ Pubmed, Embase, The Cochrane Library, Institute of Electrical and Electronics Engineers, Association of Computing Machinery digital library and Web of Science were systematically searched from January 2000 to December 2019. Included studies evaluated the impact of higher level CDSSs on process outcomes, guideline adherence and clinical outcomes. Results: 11,397 studies were selected for screening, after which 61 full-text articles were assessed for eligibility. Finally, nine studies were included in the final analysis with a total population size of 7985 patients. Types of cancer included breast cancer (63.1%), lung cancer (27.8%), prostate cancer (4.1%), colorectal cancer (3.1%) and other cancer types (1.9%). The included studies demonstrated significant improvements of higher level CDSSs on process outcomes and guideline adherence across diverse settings in oncology. No significant differences were reported for clinical outcomes. Conclusion: Higher level CDSSs seem to improve process outcomes and guidelines adherence but not clinical outcomes. It should be noticed that the included studies primarily focused on breast and lung cancer. To further explore the impact of higher level CDSSs on quality of care, high-quality research is required.
Highlights
With annually >20 million new cancer cases expected worldwide by 2025, cancer is a major health problem [1]
Three studies reported a significant increase in adherence to breast cancer guidelines (Oncolor guidelines, Cancer Est) after implementation of a clinical decision support systems (CDSSs) ranging from 9.3% to 24.1% [29,30,32]
We systematically reviewed scientific literature and identified the impact higher level CDSSs bring to oncology clinical practice, operationalized in terms of process outcomes, guideline adherence can bring to oncology clinical practice, operationalized in terms of process outcomes, guideline and clinical outcomes
Summary
Klarenbeek 1, *,† , Harm H.A. Weekenstroo 1, *,† , J.P. Michiel Sedelaar 2 , Jurgen J. Fütterer 1 , Mathias Prokop 1 and Marcia Tummers 3.
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