As providers react to inevitable shifts in evidence-based medicine, they rely on clinical decision support systems (CDS): the tools that report trusted and timely medical information. When they are adopted across the care continuum and accompanied by proper training, these resources can reduce errors, improve adherence to guidelines, and promote cost control, according to research published in NPJ Digital Medicine.
It’s because of these benefits that CDS has become ubiquitous in healthcare settings, with one report from the National Academy of Medicine calling CDS a “practical necessity for every clinician.” These tools also add value to resource-limited settings, as one physician from Kenya emphasized in a 2020 letter to the editor published in the British Medical Journal.
Despite its potential, however, CDS carries risks if the information provided is outdated, unvetted, or incorrect. These flaws can cause some clinicians to question its validity or even distrust decision support tools altogether according to an article published in the National Library of Medicine.
Does that mean all third-party CDS technologies are unreliable? Certainly not. But it does mean that medical practices should scrutinize their solutions and choose resources they trust.
How to gauge the quality of a clinical decision support system
On average, physicians encounter one unanswered question for every two patients they see, according to a study published in JAMA Internal Medicine. The CDS tools that clinicians use to answer those everyday queries must be based on sound clinical evidence.
One way to verify the accuracy of a CDS is to evaluate these resources as carefully as one evaluates medical literature: as high-impact journals have a robust peer review and editorial process, the best CDS tools do also.
In particular, when considering implementing a CDS, you should examine the resources’:
Editorial policy
A CDS tool should clearly present evidence of editorial rigor in categories such as evidence, practice-changing updates, peer review and authorship. This is a good sign that a tool has the governance necessary to maintain updated content.
Editorial process
The editorial process lays out how clinical topics are selected, created, reviewed, published, and modified.
Contributor qualifications
Trusted information comes from qualified experts. Look for the medical accreditations of content contributors and ensure that decision tools disclose the authors and editors behind every topic.
Grading guide
Ensure the CDS publisher outlines its approach to weighing recommendations, such as criteria for classifying recommendations as strong or weak or rating the quality of evidence.
Conflict of interest policy
Clinical decision support should be free of bias. A robust conflict of interest policy requires contributors (including authors and editors) to disclose their financial relationships to any studies, journals, or institutions for at least the previous two years.
What makes UpToDate different than other CDS solutions?
With more than two million subscribers, UpToDate has earned its reputation as the world’s leading evidence-based CDS tool.
This resource is built by more than 7,400 leading physician authors and physician editors who make up a vast network of domain experts and translate recently published research into original, clear, and actionable content. Before any of that content goes live, it passes through at least three layers of review from trained physician editors and peer reviewers, with their affiliations provided alongside every topic.
With this uncompromising level of scrutiny and detail, users can confidently find evidence-based answers to their clinical questions, and ultimately, improve patient care. As medicine continues to quickly evolve, having support — in real-time and at the point of care — can make all the difference.
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