Clinical Decision Support Systems Used in Transplantation: Are They Tools for Success or an Unnecessary Gadget? A Systematic Review.
| Title: | Clinical Decision Support Systems Used in Transplantation: Are They Tools for Success or an Unnecessary Gadget? A Systematic Review. |
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| Authors: | Wingfield LR; Nuffield Department of Surgical Sciences, University of Oxford, Oxford, United Kingdom.; Salaun A; Department of Engineering Science, University of Oxford, Oxford, United Kingdom.; Khan A; Department of Neurosurgery, Stanford University, Stanford, CA.; Webb H; School of Computer Science, University of Nottingham, Nottingham, United Kingdom.; Zhu T; Department of Engineering Science, University of Oxford, Oxford, United Kingdom.; Knight S; Nuffield Department of Surgical Sciences, University of Oxford, Oxford, United Kingdom. |
| Source: | Transplantation [Transplantation] 2024 Jan 01; Vol. 108 (1), pp. 72-99. Date of Electronic Publication: 2023 May 05. |
| Publication Type: | Systematic Review; Journal Article |
| Language: | English |
| Journal Info: | Publisher: Lippincott Williams & Wilkins Country of Publication: United States NLM ID: 0132144 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1534-6080 (Electronic) Linking ISSN: 00411337 NLM ISO Abbreviation: Transplantation Subsets: MEDLINE |
| Imprint Name(s): | Publication: Hagerstown, MD : Lippincott Williams & Wilkins; Original Publication: Baltimore, Williams & Wilkins. |
| MeSH Terms: | Decision Support Systems, Clinical*; Humans ; Artificial Intelligence ; Immunosuppressive Agents |
| Abstract: | Although clinical decision support systems (CDSSs) have been used since the 1970s for a wide variety of clinical tasks including optimization of medication orders, improved documentation, and improved patient adherence, to date, no systematic reviews have been carried out to assess their utilization and efficacy in transplant medicine. The aim of this study is to systematically review studies that utilized a CDSS and assess impact on patient outcomes. A total of 48 articles were identified as meeting the author-derived inclusion criteria, including tools for posttransplant monitoring, pretransplant risk assessment, waiting list management, immunosuppressant management, and interpretation of histopathology. Studies included 15 984 transplant recipients. Tools aimed at helping with transplant patient immunosuppressant management were the most common (19 studies). Thirty-four studies (85%) found an overall clinical benefit following the implementation of a CDSS in clinical practice. Although there are limitations to the existing literature, current evidence suggests that implementing CDSS in transplant clinical settings may improve outcomes for patients. Limited evidence was found using more advanced technologies such as artificial intelligence in transplantation, and future studies should investigate the role of these emerging technologies.; (Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.) |
| Competing Interests: | S.K. has received funding for clinical study design and evidence reviews from OrganOx Ltd. T.Z. was supported by the Royal Academy of Engineering under the Research Fellowship scheme. This article presents independent research funded by the National Institute for Health and Care Research under its Artificial Intelligence Program (grant AI_AWARD02316). The views expressed are those of the author(s) and not necessarily those of the NIHR or the Department of Health and Social Care. The other authors declare no conflicts of interest. |
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| Substance Nomenclature: | 0 (Immunosuppressive Agents) |
| Entry Date(s): | Date Created: 20230505 Date Completed: 20231216 Latest Revision: 20250604 |
| Update Code: | 20260130 |
| DOI: | 10.1097/TP.0000000000004627 |
| PMID: | 37143191 |
| Database: | MEDLINE |
Systematic Review; Journal Article