Clinical decision support system for the management of osteoporosis compared to NOGG guidelines and an osteology specialist: a validation pilot study

Autor: Bjorn R. Ludviksson, Haukur Tyr Gudmundsson, Karen E. Hansen, Bjarni V. Halldorsson, Bjorn Gudbjornsson
Přispěvatelé: Læknadeild (HÍ), Faculty of Medicine (UI), Heilbrigðisvísindasvið (HÍ), School of Health Sciences (UI), School of Science and Engineering (RU), Tækni- og verkfræðideild (HR), Háskóli Íslands, University of Iceland, Háskólinn í Reykjavík, Reykjavik University
Rok vydání: 2017
Předmět:
Clinical guidelines
Upplýsingakerfi
medicine.medical_specialty
FRAX
020205 medical informatics
Fracture risk
Point-of-Care Systems
Áhættuþættir
Osteoporosis
Health Informatics
Pilot Projects
02 engineering and technology
Primary care
lcsh:Computer applications to medicine. Medical informatics
Clinical decision support system
Health informatics
Risk Assessment
Physicians
Primary Care
03 medical and health sciences
0302 clinical medicine
Osteology
0202 electrical engineering
electronic engineering
information engineering
medicine
Humans
030212 general & internal medicine
Treatment recommendations
Femoral neck
Aged
Retrospective Studies
Clinical decision support system (CDSS)
business.industry
Health Policy
Guideline
Middle Aged
medicine.disease
University hospital
Decision Support Systems
Clinical
Sjúkdómsgreining
Computer Science Applications
medicine.anatomical_structure
Beinþynning
Practice Guidelines as Topic
Physical therapy
lcsh:R858-859.7
Female
business
Research Article
Zdroj: BMC Medical Informatics and Decision Making
BMC Medical Informatics and Decision Making, Vol 19, Iss 1, Pp 1-8 (2019)
ISSN: 1472-6947
Popis: Publisher's version (útgefin grein)
Background: Although osteoporosis is an easily diagnosed and treatable condition, many individuals remain untreated. Clinical decision support systems might increase appropriate treatment of osteoporosis. We designed the Osteoporosis Advisor (OPAD), a computerized tool to support physicians managing osteoporosis at the point-of-care. The present study compares the treatment recommendations provided by OPAD, an expert physician and the National Osteoporosis Guideline Group (NOGG). Methods: We performed a retrospective analysis of 259 patients attending the outpatient osteoporosis clinic at the University Hospital in Iceland. We entered each patient's data into the OPAD and recorded the OPAD diagnostic comments, 10-year risk of major osteoporotic fracture and treatment options. We compared OPAD recommendations to those given by the osteoporosis specialist, and to those of the NOGG. Results: Risk estimates made by OPAD were highly correlated with those from FRAX (r = 0.99, 95% CI 0.99, 1.00 without femoral neck BMD; r = 0.98, 95% CI, 0.97, 0.99 with femoral neck BMD. Reassurance was recommended by the expert, NOGG and the OPAD in 68, 63 and 52% of cases, respectively. Likewise, intervention was recommended by the expert, NOGG, and the OPAD in 32, 37 and 48% of cases, respectively. The OPAD demonstrated moderate agreement with the physician (kappa 0.51, 95% CI 0.41, 0.61) and even higher agreement with NOGG (kappa 0.69, 95% CI 0.60, 0.77). Conclusion: Primary care physicians can use the OPAD to assess and treat patients' skeletal health. Recommendations given by OPAD are consistent with expert opinion and existing guidelines.
This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.
Databáze: OpenAIRE
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