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Research article
Laboratory test ordering in inpatient hospitals: a systematic review on the effects and features of clinical decision support systems
Ehsan Nabovati
Kashan University of Medical Sciences
Corresponding Author
ORCiD: https://orcid.org/0000-0003-1367-5210
License:
This work is licensed under a CC BY 4.0 License. Read Full License
View the published version at BMC Medical Informatics and Decision Making.
Background: Studies have revealed inappropriate laboratory testing as a source of waste. This review aimed at evaluating the effects and features of CDSSs on physicians' appropriate laboratory test ordering in inpatient hospitals.
Method: Medline through PubMed, SCOPUS, Web of Science, and Cochrane were queried without any time period restriction. The outcomes related to the effect of CDSSs were categorized based on test-related, physician-related, and patient-related.
Result: Sixteen studies met the inclusion criteria. Most studies were conducted based on a quasi-experimental design. The results showed improvement in laboratory test-related outcomes (e.g. proportion and cost of tests) and also physician-related outcomes (e.g. guideline adherence and orders cancellation). Patient-related outcomes (e.g. length of stay and mortality rate) were not well investigated in the included studies. Also, the evidence about applying CDSS as a decision aid for interpreting laboratory results was rare.
Conclusion: CDSSs increase appropriate test ordering in hospitals through eliminating redundant test orders and enhancing evidence-based practice. Appropriate testing and cost saving were both affected by the CDSSs. However the evidence is limited about the effects of laboratory test CDSSs on patient-related outcomes.
Keywords
Clinical Decision Support System, Test ordering, Hospitals, Laboratories, Inpatients
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CURRENT STATUS: Published
Published
On 18 Jan, 2021
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Editorial decision: Accept
On 23 Dec, 2020
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On 08 Dec, 2020
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On 08 Dec, 2020
Editor invited
On 08 Dec, 2020
No comments provided
Editor assigned
On 01 Dec, 2020
Editorial decision: Minor revision
On 01 Dec, 2020
Submission checks complete
On 01 Dec, 2020
Editor invited
On 01 Dec, 2020
Version 2
Posted 15 Oct, 2020
No comments provided
Editorial decision: Major revision
On 04 Nov, 2020
Review #2 received
Received 03 Nov, 2020
Review #1 received
Received 01 Nov, 2020
Reviewer #1 agreed
On 18 Oct, 2020
Reviewer #2 agreed
On 17 Oct, 2020
Reviewers invited
Invitations sent on 15 Oct, 2020
Editor assigned
On 29 Sep, 2020
Submission checks complete
On 28 Sep, 2020
Editor invited
On 28 Sep, 2020
No comments provided
Editorial decision: Major revision
On 21 Sep, 2020
Review #2 received
Received 14 Sep, 2020
Reviewer #2 agreed
On 06 Sep, 2020
Review #1 received
Received 21 Aug, 2020
Reviewer #1 agreed
On 07 Aug, 2020
Reviewers invited
Invitations sent on 07 Aug, 2020
Editor assigned
On 22 Jul, 2020
Submission checks complete
On 21 Jul, 2020
Editor invited
On 21 Jul, 2020
First submitted
On 20 Jul, 2020
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HTML Views: ...
Subject Areas
Medical Informatics
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This preprint is under consideration at BMC Medical Informatics and Decision Making. A preprint is a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Learn more about In Review
Research article
Laboratory test ordering in inpatient hospitals: a systematic review on the effects and features of clinical decision support systems
Ehsan Nabovati
Kashan University of Medical Sciences
Corresponding Author
ORCiD: https://orcid.org/0000-0003-1367-5210
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
Peer Review Timeline
CURRENT STATUS: Published
Published
On 18 Jan, 2021
No community comments so far
Editorial decision: Accept
On 23 Dec, 2020
Editor assigned
On 08 Dec, 2020
Submission checks complete
On 08 Dec, 2020
Editor invited
On 08 Dec, 2020
No comments provided
Editor assigned
On 01 Dec, 2020
Editorial decision: Minor revision
On 01 Dec, 2020
Submission checks complete
On 01 Dec, 2020
Editor invited
On 01 Dec, 2020
Version 2
Posted 15 Oct, 2020
No comments provided
Editorial decision: Major revision
On 04 Nov, 2020
Review #2 received
Received 03 Nov, 2020
Review #1 received
Received 01 Nov, 2020
Reviewer #1 agreed
On 18 Oct, 2020
Reviewer #2 agreed
On 17 Oct, 2020
Reviewers invited
Invitations sent on 15 Oct, 2020
Editor assigned
On 29 Sep, 2020
Submission checks complete
On 28 Sep, 2020
Editor invited
On 28 Sep, 2020
No comments provided
Editorial decision: Major revision
On 21 Sep, 2020
Review #2 received
Received 14 Sep, 2020
Reviewer #2 agreed
On 06 Sep, 2020
Review #1 received
Received 21 Aug, 2020
Reviewer #1 agreed
On 07 Aug, 2020
Reviewers invited
Invitations sent on 07 Aug, 2020
Editor assigned
On 22 Jul, 2020
Submission checks complete
On 21 Jul, 2020
Editor invited
On 21 Jul, 2020
First submitted
On 20 Jul, 2020
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
Subject Areas
Medical Informatics
License:
This work is licensed under a CC BY 4.0 License. Read Full License
View the published version at BMC Medical Informatics and Decision Making.
Background: Studies have revealed inappropriate laboratory testing as a source of waste. This review aimed at evaluating the effects and features of CDSSs on physicians' appropriate laboratory test ordering in inpatient hospitals.
Method: Medline through PubMed, SCOPUS, Web of Science, and Cochrane were queried without any time period restriction. The outcomes related to the effect of CDSSs were categorized based on test-related, physician-related, and patient-related.
Result: Sixteen studies met the inclusion criteria. Most studies were conducted based on a quasi-experimental design. The results showed improvement in laboratory test-related outcomes (e.g. proportion and cost of tests) and also physician-related outcomes (e.g. guideline adherence and orders cancellation). Patient-related outcomes (e.g. length of stay and mortality rate) were not well investigated in the included studies. Also, the evidence about applying CDSS as a decision aid for interpreting laboratory results was rare.
Conclusion: CDSSs increase appropriate test ordering in hospitals through eliminating redundant test orders and enhancing evidence-based practice. Appropriate testing and cost saving were both affected by the CDSSs. However the evidence is limited about the effects of laboratory test CDSSs on patient-related outcomes.
Figure 1