Clinical validation of clinical decision support systems for medication review: A scoping review. Issue 5 (15th December 2021)

• Record Type: Journal Article
• Authors: Damoiseaux‐Volman, Birgit A.; Medlock, Stephanie; van der Meulen, Delanie M.; de Boer, Jesse; Romijn, Johannes A.; van der Velde, Nathalie; Abu‐Hanna, Ameen
• Is Part Of: British journal of clinical pharmacology. Volume 88:Issue 5(2022)
• Page Start: 2035
• Page End: 2051
• Publication Date: 2021-12-15
• Subjects: adverse drug events -- clinical decision support systems -- inappropriate prescriptions -- validation studies; Pharmacology -- Periodicals; Drugs -- Periodicals; 615.1
• DOI: 10.1111/bcp.15160
• Languages: English
• ISSNs: 0306-5251

Abstract

Abstract : The aim of this scoping review is to summarize approaches and outcomes of clinical validation studies of clinical decision support systems (CDSSs) to support (part of) a medication review. A literature search was conducted in Embase and Medline. In total, 30 articles validating a CDSS were ultimately included. Most of the studies focused on detection of adverse drug events, potentially inappropriate medications and drug‐related problems. We categorized the included articles in three groups: studies subjectively reviewing the clinical relevance of CDSS's output (21/30 studies) resulting in a positive predictive value (PPV) for clinical relevance of 4–80%; studies determining the relationship between alerts and actual events (10/30 studies) resulting in a PPV for actual events of 5–80%; and studies comparing output of CDSSs to chart/medication reviews in the whole study population (10/30 studies) resulting in a sensitivity of 28–85% and specificity of 42–75%. We found heterogeneity in the methods used and in the outcome measures. The validation studies did not report the use of a published CDSS validation strategy. To improve the effectiveness and uptake of CDSSs supporting a medication review, future research would benefit from a more systematic and comprehensive validation strategy.