Knowledge-based, computerized, patient clinical decision support system for perioperative pain, nausea and constipation management: a clinical feasibility study.
Autor: | Noll E; Department of Anesthesiology, Intensive Care and Perioperative Medicine, Hautepierre Hospital, Strasbourg University Hospitals, Strasbourg, France. Eric.noll@chru-strasbourg.fr., Noll-Burgin M; Department of Pharmacy, Groupe Hospitalier Saint Vincent, Strasbourg, France., Bonnomet F; Department of Orthopedic and Trauma Surgery, Hautepierre Hospital, Strasbourg University Hospitals, Strasbourg, France., Reiter-Schatz A; Department of Pharmacy, Hautepierre Hospital, Strasbourg University Hospitals, Strasbourg, France., Gourieux B; Department of Pharmacy, Hautepierre Hospital, Strasbourg University Hospitals, Strasbourg, France., Bennett-Guerrero E; Department of Anesthesiology, Stony-Brook Medicine, Stony-Brook, NY, USA., Goetsch T; Department of Biostatistics, Strasbourg University Hospitals, Strasbourg, France., Meyer N; Department of Biostatistics, Strasbourg University Hospitals, Strasbourg, France., Pottecher J; Department of Anesthesiology and Intensive Care, Hautepierre Hospital, Strasbourg University Hospitals, Strasbourg, France. |
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Jazyk: | angličtina |
Zdroj: | Journal of clinical monitoring and computing [J Clin Monit Comput] 2024 Aug; Vol. 38 (4), pp. 907-913. Date of Electronic Publication: 2024 Apr 12. |
DOI: | 10.1007/s10877-024-01148-z |
Abstrakt: | Opioid administration is particularly challenging in the perioperative period. Computerized-based Clinical Decision Support Systems (CDSS) are a promising innovation that might improve perioperative pain control. We report the development and feasibility validation of a knowledge-based CDSS aiming at optimizing the management of perioperative pain, postoperative nausea and vomiting (PONV), and laxative medications. This novel CDSS uses patient adaptive testing through a smartphone display, literature-based rules, and individual medical prescriptions to produce direct medical advice for the patient user. Our objective was to test the feasibility of the clinical use of our CDSS in the perioperative setting. This was a prospective single arm, single center, cohort study conducted in Strasbourg University Hospital. The primary outcome was the agreement between the recommendation provided by the experimental device and the recommendation provided by study personnel who interpreted the same care algorithm (control). Thirty-seven patients were included in the study of which 30 (81%) used the experimental device. Agreement between these two care recommendations (computer driven vs. clinician driven) was observed in 51 out 54 uses of the device (94.2% [95% CI 85.9-98.4%]). The agreement level had a probability of 86.6% to exceed the 90% clinically relevant agreement threshold. The knowledge-based, patient CDSS we developed was feasible at providing recommendations for the treatment of pain, PONV and constipation in a perioperative clinical setting.Trial registration number & date The study protocol was registered in ClinicalTrial.gov before enrollment began (NCT05707247 on January 26th, 2023). (© 2024. The Author(s).) |
Databáze: | MEDLINE |
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