To the Editor Dr Hussey and colleagues1 reported that the majority of orders for advanced diagnostic imaging before (63.3%) and after (66.5%) implementation of clinical decision support (CDS) systems could not be matched to appropriateness criteria. This suggests a serious deficiency in the usefulness of CDS systems.
Our hypothesis is that this was not a problem with the guidelines or the quality of the CDS system software itself, but rather an issue with the underlying data submitted to the CDS systems for analysis. For a CDS system to be able to suggest appropriate treatment, it must have access not only to the order itself but to the entire patient record in a computable format.2
Cook TW, Cavalini LT. Clinical Decision Support Systems and Advanced Diagnostic Imaging. JAMA. 2015;314(14):1518-1519. doi:10.1001/jama.2015.10919