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Title:	A guideline-based decision support for pharmacological treatment can improve the quality of hyperlipidemia management
Authors:	Chen, Kung 陳恭
Contributors:	資科系
Keywords:	Clinical decision support systems;Clinical practice guidelines;Evidence-based medicine;Hyperlipidemia;Order entry;Order entry system;Artificial intelligence;Decision making;Decision theory;Hospital data processing;Decision support systems;hydroxymethylglutaryl coenzyme A reductase inhibitor;low density lipoprotein cholesterol;aged;algorithm;article;cholesterol blood level;clinical effectiveness;decision support system;female;health care quality;human;hyperlipidemia;major clinical study;male;performance measurement system;practice guideline;prescription;Decision Support Systems, Clinical;Guidelines as Topic;Humans;Hyperlipidemias;Quality of Health Care
Date:	2010-03
Issue Date:	2015-06-15 17:46:06 (UTC+8)
Abstract:	Introduction: The Institute of Medicine has identified both Computerized Physician Order Entry (CPOE) and Electronic Prescription (EP) as key in reducing medication errors and improving safety. Many computerized clinical decision support systems (CDSSs) improve practitioner performance. However, the development of CDSSs involves a long cycle time that makes it difficult to apply in a wider scope. Methods: In this study, we integrated the hyperlipidemia treatment guideline ATP III (Adult Treatment Panel III) in a CPOE of a medical center. The first 200 consecutive patients followed up more than 1 year were recorded for analysis. Results: Our study revealed that 130 (65%) patients reached the LDL-C (low density lipoprotein-cholesterol) goal in 1 year. For those who with CDSS finished, 74% reached the LDL-C goal. For those who with CDSS exited, 57% reached the LDL-C goal. The odds ratio is 2.1 (1.2, 3.8) (p = 0.022), which means for those who with CDSS finished can have 2 times of chance to reach the LDL-C goal. The mean of days to attain the LDL-C goal level after initiation of antihyperlipidemia therapy was 175 ± 98 days. 11,806 prescribing records from 8023 patients were collected for analyzing the reasons of prematurely exiting the CDSS. The most frequent reason for exiting the system is "too busy to use". Conclusion: We conclude that a CPOE with CDSS integrated may let more hyperlipidemia patients reach the LDL-C goal. However, data also showed the total prescribing time may increase. The results of a preliminary evaluation are presented to illustrate that the CDSSs can improve the quality of hyperlipidemia management. © 2009 Elsevier Ireland Ltd. All rights reserved.
Relation:	Computer Methods and Programs in Biomedicine,Volume 97, Issue 3, Pages 280-285
Data Type:	article
DOI link:	http://dx.doi.org/10.1016/j.cmpb.2009.12.004
DOI:	10.1016/j.cmpb.2009.12.004
Appears in Collections:	[Department of Computer Science ] Periodical Articles

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