Use and Evaluation of Computerized Clinical Decision Support Systems for Early Detection of Sepsis in Hospitals: Protocol for a Scoping Review

Li, Ling; Ackermann, Khalia; Baker, Jannah; Westbrook, Johanna I.

doi:10.2196/24899

Cited by 9 publications

(16 citation statements)

References 44 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The detailed methodology for conducting this scoping review was published previously in a protocol [ 26 ]. In brief, the review was guided by the Joanna Briggs Institute Reviewer’s Manual [ 27 ], the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews) [ 28 ], and the 5-stage scoping review framework proposed by Arksey and O’Malley [ 29 ].…”

Section: Methodsmentioning

confidence: 99%

“…We used a broad 3-step search strategy, as outlined in our protocol [ 26 ]. An experienced librarian was consulted to help construct and refine the search.…”

Section: Methodsmentioning

confidence: 99%

“…However, we kept studies if they reported the same methods and study cohort but examined different outcomes. Using the eligibility criteria as reported in our protocol [ 26 ], 2 reviewers (KA and JB) independently performed title, abstract, and full-text screening, with any disagreements resolved through discussion or review by a third researcher (LL). Title and abstract screening was piloted with a random selection of 25 studies by both reviewers (KA and JB).…”

Section: Methodsmentioning

confidence: 99%

“…The final data charting form included the components listed in our protocol [ 26 ], with minor adjustments as reported in Multimedia Appendix 3 [ 33 - 39 ]. Notably, an additional category clarity of outcome reporting was added to the form to account for the variability in outcome reporting transparency.…”

Section: Methodsmentioning

confidence: 99%

See 3 more Smart Citations

Computerized Clinical Decision Support Systems for the Early Detection of Sepsis Among Adult Inpatients: Scoping Review

Ackermann¹,

Baker²,

Green³

et al. 2022

J Med Internet Res

Self Cite

View full text Add to dashboard Cite

Background Sepsis is a significant cause of morbidity and mortality worldwide. Early detection of sepsis followed promptly by treatment initiation improves patient outcomes and saves lives. Hospitals are increasingly using computerized clinical decision support (CCDS) systems for the rapid identification of adult patients with sepsis. Objective This scoping review aims to systematically describe studies reporting on the use and evaluation of CCDS systems for the early detection of adult inpatients with sepsis. Methods The protocol for this scoping review was previously published. A total of 10 electronic databases (MEDLINE, Embase, CINAHL, the Cochrane database, LILACS [Latin American and Caribbean Health Sciences Literature], Scopus, Web of Science, OpenGrey, ClinicalTrials.gov, and PQDT [ProQuest Dissertations and Theses]) were comprehensively searched using terms for sepsis, CCDS, and detection to identify relevant studies. Title, abstract, and full-text screening were performed by 2 independent reviewers using predefined eligibility criteria. Data charting was performed by 1 reviewer with a second reviewer checking a random sample of studies. Any disagreements were discussed with input from a third reviewer. In this review, we present the results for adult inpatients, including studies that do not specify patient age. Results A search of the electronic databases retrieved 12,139 studies following duplicate removal. We identified 124 studies for inclusion after title, abstract, full-text screening, and hand searching were complete. Nearly all studies (121/124, 97.6%) were published after 2009. Half of the studies were journal articles (65/124, 52.4%), and the remainder were conference abstracts (54/124, 43.5%) and theses (5/124, 4%). Most studies used a single cohort (54/124, 43.5%) or before-after (42/124, 33.9%) approach. Across all 124 included studies, patient outcomes were the most frequently reported outcomes (107/124, 86.3%), followed by sepsis treatment and management (75/124, 60.5%), CCDS usability (14/124, 11.3%), and cost outcomes (9/124, 7.3%). For sepsis identification, the systemic inflammatory response syndrome criteria were the most commonly used, alone (50/124, 40.3%), combined with organ dysfunction (28/124, 22.6%), or combined with other criteria (23/124, 18.5%). Over half of the CCDS systems (68/124, 54.8%) were implemented alongside other sepsis-related interventions. Conclusions The current body of literature investigating the implementation of CCDS systems for the early detection of adult inpatients with sepsis is extremely diverse. There is substantial variability in study design, CCDS criteria and characteristics, and outcomes measured across the identified literature. Future research on CCDS system usability, cost, and impact on sepsis morbidity is needed. International Registered Report Identifier (IRRID) RR2-10.2196/24899

show abstract

Section: Methodsmentioning

confidence: 99%

“…We used a broad 3-step search strategy, as outlined in our protocol [ 26 ]. An experienced librarian was consulted to help construct and refine the search.…”

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

See 2 more Smart Citations

Computerized Clinical Decision Support Systems for the Early Detection of Sepsis Among Adult Inpatients: Scoping Review

Ackermann¹,

Baker²,

Green³

et al. 2022

J Med Internet Res

Self Cite

View full text Add to dashboard Cite

show abstract

“…A protocol detailing the methodology of this scoping review has been previously published [ 41 ]. This review follows the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews) statement [ 42 ].…”

Section: Methodsmentioning

confidence: 99%

Computerized Clinical Decision Support Systems for the Early Detection of Sepsis Among Pediatric, Neonatal, and Maternal Inpatients: Scoping Review

Ackermann¹,

Baker²,

Festa³

et al. 2022

JMIR Med Inform

Self Cite

View full text Add to dashboard Cite

Background Sepsis is a severe condition associated with extensive morbidity and mortality worldwide. Pediatric, neonatal, and maternal patients represent a considerable proportion of the sepsis burden. Identifying sepsis cases as early as possible is a key pillar of sepsis management and has prompted the development of sepsis identification rules and algorithms that are embedded in computerized clinical decision support (CCDS) systems. Objective This scoping review aimed to systematically describe studies reporting on the use and evaluation of CCDS systems for the early detection of pediatric, neonatal, and maternal inpatients at risk of sepsis. Methods MEDLINE, Embase, CINAHL, Cochrane, Latin American and Caribbean Health Sciences Literature (LILACS), Scopus, Web of Science, OpenGrey, ClinicalTrials.gov, and ProQuest Dissertations and Theses Global (PQDT) were searched by using a search strategy that incorporated terms for sepsis, clinical decision support, and early detection. Title, abstract, and full-text screening was performed by 2 independent reviewers, who consulted a third reviewer as needed. One reviewer performed data charting with a sample of data. This was checked by a second reviewer and via discussions with the review team, as necessary. Results A total of 33 studies were included in this review—13 (39%) pediatric studies, 18 (55%) neonatal studies, and 2 (6%) maternal studies. All studies were published after 2011, and 27 (82%) were published from 2017 onward. The most common outcome investigated in pediatric studies was the accuracy of sepsis identification (9/13, 69%). Pediatric CCDS systems used different combinations of 18 diverse clinical criteria to detect sepsis across the 13 identified studies. In neonatal studies, 78% (14/18) of the studies investigated the Kaiser Permanente early-onset sepsis risk calculator. All studies investigated sepsis treatment and management outcomes, with 83% (15/18) reporting on antibiotics-related outcomes. Usability and cost-related outcomes were each reported in only 2 (6%) of the 31 pediatric or neonatal studies. Both studies on maternal populations were short abstracts. Conclusions This review found limited research investigating CCDS systems to support the early detection of sepsis among pediatric, neonatal, and maternal patients, despite the high burden of sepsis in these vulnerable populations. We have highlighted the need for a consensus definition for pediatric and neonatal sepsis and the study of usability and cost-related outcomes as critical areas for future research. International Registered Report Identifier (IRRID) RR2-10.2196/24899

show abstract

Trends on Decision Support Systems: A Bibliometric Review

García-Alcaráz

Sánchez-Ramírez

Díaz-Reza

et al. 2022

Handbook on Decision Making

View full text Add to dashboard Cite

Use and Evaluation of Computerized Clinical Decision Support Systems for Early Detection of Sepsis in Hospitals: Protocol for a Scoping Review

Cited by 9 publications

References 44 publications

Computerized Clinical Decision Support Systems for the Early Detection of Sepsis Among Adult Inpatients: Scoping Review

Computerized Clinical Decision Support Systems for the Early Detection of Sepsis Among Adult Inpatients: Scoping Review

Computerized Clinical Decision Support Systems for the Early Detection of Sepsis Among Pediatric, Neonatal, and Maternal Inpatients: Scoping Review

Trends on Decision Support Systems: A Bibliometric Review

Contact Info

Product

Resources

About