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 |
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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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