IDEAS home Printed from https://ideas.repec.org/a/plo/pone00/0272846.html

Towards effective clinical decision support systems: A systematic review

Author

Listed:
  • Francini Hak
  • Tiago Guimarães
  • Manuel Santos

Abstract

Background: Clinical Decision Support Systems (CDSS) are used to assist the decision-making process in the healthcare field. Developing an effective CDSS is an arduous task that can take advantage from prior assessment of the most promising theories, techniques and methods used at the present time. Objective: To identify the features of Clinical Decision Support Systems and provide an analysis of their effectiveness. Thus, two research questions were formulated: RQ1—What are the most common trend characteristics in a CDSS? RQ2—What is the maturity level of the CDSS based on the decision-making theory proposed by Simon? Methods: AIS e-library, Decision Support Systems journal, Nature, PlosOne and PubMed were selected as information sources to conduct this systematic literature review. Studies from 2000 to 2020 were chosen covering search terms in CDSS, selected according to defined eligibility criteria. The data were extracted and managed in a worksheet, based on the defined criteria. PRISMA statements were used to report the systematic review. Results: The outcomes showed that rule-based module was the most used approach regarding knowledge management and representation. The most common technological feature adopted by the CDSS were the recommendations and suggestions. 19,23% of studies adopt the type of system as a web-based application, and 51,92% are standalone CDSS. Temporal evolution was also possible to visualize. This study contributed to the development of a Maturity Staging Model, where it was possible to verify that most CDSS do not exceed level 2 of maturity. Conclusion: The trend characteristics addressed in the revised CDSS were identified, compared to the four predefined groups. A maturity stage model was developed based on Simon’s decision-making theory, allowing to assess the level of maturity of the most common features of the CDSS. With the application of the model, it was noticed that the phases of choice and implementation are underrepresented. This constitutes the main gap in the development of an effective CDSS.

Suggested Citation

  • Francini Hak & Tiago Guimarães & Manuel Santos, 2022. "Towards effective clinical decision support systems: A systematic review," PLOS ONE, Public Library of Science, vol. 17(8), pages 1-19, August.
    • Handle: RePEc:plo:pone00:0272846
    DOI: 10.1371/journal.pone.0272846
    as

    Download full text from publisher

    File URL: https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0272846
    Download Restriction: no
    File URL: https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0272846&type=printable
    Download Restriction: no
    File URL: https://libkey.io/10.1371/journal.pone.0272846?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    References listed on IDEAS

    as
    1. Cirlene de Lima Marinho & Maria Christina Paixão Maioli & Jorge Luis Machado do Amaral & Agnaldo José Lopes & Pedro Lopes de Melo, 2019. "Respiratory resistance and reactance in adults with sickle cell anemia: Part 2—Fractional-order modeling and a clinical decision support system for the diagnosis of respiratory disorders," PLOS ONE, Public Library of Science, vol. 14(3), pages 1-21, March.
    2. Xia Jiang & Alan Wells & Adam Brufsky & Richard Neapolitan, 2019. "A clinical decision support system learned from data to personalize treatment recommendations towards preventing breast cancer metastasis," PLOS ONE, Public Library of Science, vol. 14(3), pages 1-18, March.
    3. repec:plo:pone00:0173021 is not listed on IDEAS
    4. David Moher & Alessandro Liberati & Jennifer Tetzlaff & Douglas G Altman & The PRISMA Group, 2009. "Preferred Reporting Items for Systematic Reviews and Meta-Analyses: The PRISMA Statement," PLOS Medicine, Public Library of Science, vol. 6(7), pages 1-6, July.
    5. Pengli Jia & Longhao Zhang & Jingjing Chen & Pujing Zhao & Mingming Zhang, 2016. "The Effects of Clinical Decision Support Systems on Medication Safety: An Overview," PLOS ONE, Public Library of Science, vol. 11(12), pages 1-17, December.
    6. repec:plo:pone00:0237159 is not listed on IDEAS
    7. Christopher E Curtis & Fares Al Bahar & John F Marriott, 2017. "The effectiveness of computerised decision support on antibiotic use in hospitals: A systematic review," PLOS ONE, Public Library of Science, vol. 12(8), pages 1-15, August.
    Full references (including those not matched with items on IDEAS)

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. İlkay Unay-Gailhard & Mark A. Brennen, 2022. "How digital communications contribute to shaping the career paths of youth: a review study focused on farming as a career option," Agriculture and Human Values, Springer;The Agriculture, Food, & Human Values Society (AFHVS), vol. 39(4), pages 1491-1508, December.
    2. Mahin Ghafari & Vali Baigi & Zahra Cheraghi & Amin Doosti-Irani, 2016. "The Prevalence of Asymptomatic Bacteriuria in Iranian Pregnant Women: A Systematic Review and Meta-Analysis," PLOS ONE, Public Library of Science, vol. 11(6), pages 1-10, June.
    3. Santos Urbina & Sofía Villatoro & Jesús Salinas, 2021. "Self-Regulated Learning and Technology-Enhanced Learning Environments in Higher Education: A Scoping Review," Sustainability, MDPI, vol. 13(13), pages 1-12, June.
    4. Nadine Desrochers & Adèle Paul‐Hus & Jen Pecoskie, 2017. "Five decades of gratitude: A meta‐synthesis of acknowledgments research," Journal of the Association for Information Science & Technology, Association for Information Science & Technology, vol. 68(12), pages 2821-2833, December.
    5. Maryono, Maryono & Killoes, Aditya Marendra & Adhikari, Rajendra & Abdul Aziz, Ammar, 2024. "Agriculture development through multi-stakeholder partnerships in developing countries: A systematic literature review," Agricultural Systems, Elsevier, vol. 213(C).
    6. Alene Sze Jing Yong & Yi Heng Lim & Mark Wing Loong Cheong & Ednin Hamzah & Siew Li Teoh, 2022. "Willingness-to-pay for cancer treatment and outcome: a systematic review," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 23(6), pages 1037-1057, August.
    7. Sarah H. Son-Theroux & Olivera J. Bogunovic, 2025. "Meeting Carer Health Information Needs in Mental Health: An Integrative Review," Clinical Nursing Research, , vol. 34(5), pages 244-254, June.
    8. Agnieszka A. Tubis & Katarzyna Grzybowska, 2022. "In Search of Industry 4.0 and Logistics 4.0 in Small-Medium Enterprises—A State of the Art Review," Energies, MDPI, vol. 15(22), pages 1-26, November.
    9. García-Poole, Chloe & Byrne, Sonia & Rodrigo, María José, 2019. "How do communities intervene with adolescents at psychosocial risk? A systematic review of positive development programs," Children and Youth Services Review, Elsevier, vol. 99(C), pages 194-209.
    10. Qing Ye & Bao-Xin Qian & Wei-Li Yin & Feng-Mei Wang & Tao Han, 2016. "Association between the HFE C282Y, H63D Polymorphisms and the Risks of Non-Alcoholic Fatty Liver Disease, Liver Cirrhosis and Hepatocellular Carcinoma: An Updated Systematic Review and Meta-Analysis of 5,758 Cases and 14,741 Controls," PLOS ONE, Public Library of Science, vol. 11(9), pages 1-17, September.
    11. Bishal Mohindru & David Turner & Tracey Sach & Diana Bilton & Siobhan Carr & Olga Archangelidi & Arjun Bhadhuri & Jennifer A. Whitty, 2020. "Health State Utility Data in Cystic Fibrosis: A Systematic Review," PharmacoEconomics - Open, Springer, vol. 4(1), pages 13-25, March.
    12. Neal R. Haddaway & Matthew J. Page & Chris C. Pritchard & Luke A. McGuinness, 2022. "PRISMA2020: An R package and Shiny app for producing PRISMA 2020‐compliant flow diagrams, with interactivity for optimised digital transparency and Open Synthesis," Campbell Systematic Reviews, John Wiley & Sons, vol. 18(2), June.
    13. Ding Zhu & Mindan Wu & Yuan Cao & Shihua Lin & Nanxia Xuan & Chen Zhu & Wen Li & Huahao Shen, 2018. "Heated humidification did not improve compliance of positive airway pressure and subjective daytime sleepiness in obstructive sleep apnea syndrome: A meta-analysis," PLOS ONE, Public Library of Science, vol. 13(12), pages 1-16, December.
    14. Pelai, Ricardo & Hagerman, Shannon M. & Kozak, Robert, 2020. "Biotechnologies in agriculture and forestry: Governance insights from a comparative systematic review of barriers and recommendations," Forest Policy and Economics, Elsevier, vol. 117(C).
    15. Cocco, Edoardo & Hashimoto, Yuji Z. & Chopin, Julien, 2025. "Child sexual abuse in the catholic church: A scoping review of characteristics, prevalence, and explanatory factors," Journal of Criminal Justice, Elsevier, vol. 101(C).
    16. Wesam Salah Alaloul & Muhammad Altaf & Muhammad Ali Musarat & Muhammad Faisal Javed & Amir Mosavi, 2021. "Systematic Review of Life Cycle Assessment and Life Cycle Cost Analysis for Pavement and a Case Study," Sustainability, MDPI, vol. 13(8), pages 1-38, April.
    17. Joesri Mohamad Saber & Kardina Kamaruddin, 2025. "A Bibliometric Analysis of Training, Competencies, and Job Readiness in the Hotel and Tourism Industry: Trends and Future Directions," International Journal of Research and Innovation in Social Science, International Journal of Research and Innovation in Social Science (IJRISS), vol. 9(14), pages 282-297, February.
    18. Mekuriaw Nibret Aweke & Elsa Awoke Fentie & Muluken Chanie Agimas & Lemlem Daniel Baffa & Ever Siyoum Shewarega & Aysheshim Kassahun Belew & Esmael Ali Muhammad & Berhanu Mengistu, 2025. "Folic acid supplementation during preconception period in sub-Saharan African countries: A systematic review and meta-analysis," PLOS ONE, Public Library of Science, vol. 20(1), pages 1-24, January.
    19. Claudia Peters & Agnessa Kozak & Albert Nienhaus & Anja Schablon, 2020. "Risk of Occupational Latent Tuberculosis Infection among Health Personnel Measured by Interferon-Gamma Release Assays in Low Incidence Countries—A Systematic Review and Meta-Analysis," IJERPH, MDPI, vol. 17(2), pages 1-16, January.
    20. Sehee Kim & Mihyeon Park & Sukhee Ahn, 2022. "The Impact of Antepartum Depression and Postpartum Depression on Exclusive Breastfeeding: A Systematic Review and Meta-Analysis," Clinical Nursing Research, , vol. 31(5), pages 866-880, June.

    More about this item

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:plo:pone00:0272846. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: plosone (email available below). General contact details of provider: https://journals.plos.org/plosone/ .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.