Original InvestigationPathogenesis and Treatment of Kidney DiseaseUse of Clinical Decision Support Systems for Kidney-Related Drug Prescribing: A Systematic Review
Section snippets
Design and Study Selection
We conducted this systematic review in accordance with a prespecified protocol and reported results according to PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines.14 To facilitate CDSS identification, we classified systems by the inferencing mechanism that controlled the system's output; computerized systems driven by computerized logic and manual systems by human logic. However, both manual and computerized CDSSs use predefined guidelines (algorithms) to
Study Selection
We screened 13,785 citations, reviewed 404 articles in full text, and identified 32 studies that met our criteria for review.17, 18, 19, 20, 21, 22, 23, 24, 25, 26, 27, 28, 29, 30, 31, 32, 33, 34, 35, 36, 37, 38, 39, 40, 41, 42, 43, 44, 45, 46, 47, 48 The study selection flow diagram is shown in Fig 1. Chance-corrected agreement between the 2 independent reviewers for assessment of full-text study eligibility was excellent (Īŗ, 0.80; 95% confidence interval, 0.69-0.91). We successfully contacted
Discussion
Our systematic review summarizes 32 unique computerized and manual CDSSs that aid kidney-related drug prescribing. Both computerized and manual CDSSs primarily adjust drug prescribing in reference to the level of decreased kidney function, with other systems doing so in response to serum drug concentrations or a clinical parameter (eg, hemoglobin level). Certainly, beneficial outcomes of CDSS use may be reported selectively in the literature (ie, the file drawer effect for those that proved
Acknowledgements
We thank Mr Dariusz Gozdzik, Dr Michael Beyea, Mr Stephen Woo, and Ms Patricia Hizo-Abes for their contributions.
Support: Ms Shariff is supported by the Canadian Institutes of Health Research (CIHR) Doctoral Research Award. Dr Garg is supported by a Clinician Scientist Award from the CIHR.
Financial Disclosure: The authors declare that they have no other relevant financial interests.
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Originally published online September 26, 2011.