Photo by Piotr Bodzek
Team performing surgery
The use of computerized clinical decision support systems can reduce the risk of venous thromboembolism (VTE) among surgical patients, according to new research.
Results of a review and meta-analysis showed that use of these computerized systems was associated with a significant increase in the proportion of surgical patients with adequate VTE prophylaxis and a significant decrease in the patients’ risk of developing VTE.
Zachary M. Borab, of the New York University School of Medicine in New York, New York, and his colleagues reported these findings in JAMA Surgery.
A computerized clinical decision support system is rule or algorithm-based software that can be integrated into an electronic health record and uses data to present evidence-based knowledge at the individual patient level.
Borab and his colleagues conducted a review and meta-analysis to assess the effect of such systems on increasing adherence to VTE prophylaxis guidelines and decreasing post-operative VTEs, when compared with routine care.
The researchers combed through several databases looking for studies of surgical patients in which investigators compared routine care to computerized clinical decision support systems with VTE risk stratification and assistance in ordering VTE prophylaxis.
The team found 11 studies that were eligible for meta-analysis—9 prospective and 2 retrospective trials. The trials included a total of 156,366 patients—104,241 in the computerized clinical decision support systems group and 52,125 in the control group.
Analysis of these data revealed that using the computerized systems was associated with a significant increase in the rate of appropriate ordering of VTE prophylaxis. The odds ratio was 2.35 (95% CI, 1.78-3.10; P<0.001).
Use of the computerized systems was also associated with a significant decrease in the risk of VTE. The risk ratio was 0.78 (95% CI, 0.72-0.85; P<0.001).
Based on these results, Borab and his colleagues concluded that computerized clinical decision support systems should be used to help clinicians assess the risk of VTE and provide the appropriate prophylaxis in surgical patients.
