Clinical Decision Support Systems for Diagnosis in Primary Care: A Scoping Review

Abstract

Diagnosis is one of the crucial tasks performed by primary care physicians; however, primary care is at high risk of diagnostic errors due to the characteristics and uncertainties associated with the field. Prevention of diagnostic errors in primary care requires urgent action, and one of the possible methods is the use of health information technology. Its modes such as clinical decision support systems (CDSS) have been demonstrated to improve the quality of care in a variety of medical settings, including hospitals and primary care centers, though its usefulness in the diagnostic domain is still unknown. We conducted a scoping review to confirm the usefulness of the CDSS in the diagnostic domain in primary care and to identify areas that need to be explored. Search terms were chosen to cover the three dimensions of interest: decision support systems, diagnosis, and primary care. A total of 26 studies were included in the review. As a result, we found that the CDSS and reminder tools have significant effects on screening for common chronic diseases; however, the CDSS has not yet been fully validated for the diagnosis of acute and uncommon chronic diseases. Moreover, there were few studies involving non-physicians.

Primary Care, Burnout, and Patient Safety: Way to Eliminate Avoidable Harm

“…Since we only have limited time in ambulatory encounters, clinicians often use system 1 thinking, an intuitive process based on their own experiences. Due to uncertainties related to ambulatory medicine, it is crucial to employ the system 2 approach and further optimizae diagnostic strategies, implantat a system enabling feedback to be provided clinicians regarding diagnostic errors, and involve patients and caregivers [ 9 , 10 ].…”

Bandemia as an Early Predictive Marker of Bacteremia: A Retrospective Cohort Study

“…The clinical decision support system (CDSS) has been demonstrated to improve the quality of medical care in various medical settings; however, its usefulness in diagnosing acute illnesses has not yet been verified [ 22 ]. Most of the studies on CDSS in bacteremia were aimed at management and surveillance, and the only report on the prediction of bacteremia by the CDSS is “TREAT” by Paul et al [ 23 ].…”

Hierarchical Two-Stage Cost-Sensitive Clinical Decision Support System for Screening Prodromal Alzheimer’s Disease and Related Dementias

“…Studies implementing CDS systems have demonstrated improved diagnostic accuracy and documentation, as well as reduced diagnostic error [21,22]. CDS systems can also improve screening for common chronic diseases such as cancer, kidney disease, obesity, abdominal aortic aneurysm, diabetes, osteoporosis, hepatitis B virus, depression, and dementia, leading to improved rates of diagnosis [23,24]. There is clear potential for CDS systems to help close the gap between healthcare provider knowledge and performance for a more robust clinical decision-making system.…”