Abstract
BackgroundThe potential role of DSS in CVD prevention remains unclear as only a few studies report on patient outcomes for cardiovascular disease.Methods and ResultsA systematic review and meta-analysis of randomised controlled trials and observational studies was done using Medline, Embase, Cochrane Library, PubMed, Amed, CINAHL, Web of Science, Scopus databases; reference lists of relevant studies to 30 July 2011; and email contact with experts. The primary outcome was prevention of cardiovascular disorders (myocardial infarction, stroke, coronary heart disease, peripheral vascular disorders and heart failure) and management of hypertension owing to decision support systems, clinical decision supports systems, computerized decision support systems, clinical decision making tools and medical decision making (interventions). From 4116 references ten studies met our inclusion criteria (including 16,312 participants). Five papers reported outcomes on blood pressure management, one paper on heart failure, two papers each on stroke, and coronary heart disease. The pooled estimate for CDSS versus control group differences in SBP (mm of Hg) was - 0.99 (95% CI −3.02 to 1.04 mm of Hg; I2 = 0; p = 0.851).ConclusionsDSS show an insignificant benefit in the management and control of hypertension (insignificant reduction of SBP). The paucity of well-designed studies on patient related outcomes is a major hindrance that restricts interpretation for evaluating the role of DSS in secondary prevention. Future studies on DSS should (1) evaluate both physician performance and patient outcome measures (2) integrate into the routine clinical workflow with a provision for decision support at the point of care.
Highlights
Numerous guidelines exist for prevention of CVD, risk factor control remains sub-optimal in high-risk patients and in those with established CVD [1]
Decision Support System (DSS) show an insignificant benefit in the management and control of hypertension
Full-text assessment of the 59 potentially relevant articles resulted in 10 eligible studies that were included in our analyses
Summary
Numerous guidelines exist for prevention of CVD, risk factor control remains sub-optimal in high-risk patients and in those with established CVD [1]. DSS could be efficient and low cost tools for primary care in the prevention of cardiovascular disease, only a few studies report on patient outcomes for cardiovascular disease and the potential role of DSS for the CVD prevention remains unclear [8]. We aimed to systematically search for all the available studies that report the effect of DSS on prevention of cardiovascular disease. The potential role of DSS in CVD prevention remains unclear as only a few studies report on patient outcomes for cardiovascular disease
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