Laboratory test ordering in inpatient hospitals: a systematic review on the effects and features of clinical decision support systems
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.
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Laboratory test ordering in inpatient hospitals: a systematic review on the effects and features of clinical decision support systems
On 18 Jan, 2021
On 23 Dec, 2020
On 08 Dec, 2020
On 08 Dec, 2020
On 08 Dec, 2020
On 01 Dec, 2020
On 01 Dec, 2020
On 01 Dec, 2020
On 01 Dec, 2020
Posted 15 Oct, 2020
On 04 Nov, 2020
Received 03 Nov, 2020
Received 01 Nov, 2020
On 18 Oct, 2020
On 17 Oct, 2020
Invitations sent on 15 Oct, 2020
On 29 Sep, 2020
On 28 Sep, 2020
On 28 Sep, 2020
On 21 Sep, 2020
Received 14 Sep, 2020
On 06 Sep, 2020
Received 21 Aug, 2020
On 07 Aug, 2020
Invitations sent on 07 Aug, 2020
On 22 Jul, 2020
On 21 Jul, 2020
On 21 Jul, 2020
On 20 Jul, 2020
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