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    Clinical Decision Support

    Explore the latest in clinical decision support, including recent advances in EHR, mobile, and patient-oriented point-of-care decision tools.

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    • Developing a Framework and Electronic Tool for Communicating Diagnostic Uncertainty in Primary Care: A Qualitative Study
      JAMA Network Open
      Research
      March 9, 2023

      This qualitative study describes the development of a tool to audio record the clinician and patient interaction during a patient encounter to communicate diagnostic uncertainty.

      Health Informatics Electronic Health Records Shared Decision Making and Communication
      Full Text | pdf link PDF open access
    • Long-term Effect of Machine Learning–Triggered Behavioral Nudges on Serious Illness Conversations and End-of-Life Outcomes Among Patients With Cancer: A Randomized Clinical Trial
      JAMA Oncology
      Research
      March 1, 2023

      This randomized clinical trial assesses the impact of behavioral nudges to clinicians on the rate of serious illness conversations and end-of-life outcomes among patients at high risk of death.

      Oncology End of Life Health Informatics
      Full Text | pdf link PDF open access
    • Low Vision Rehabilitation Service Utilization Before and After Implementation of a Clinical Decision Support System in Ophthalmology
      JAMA Network Open
      Research
      February 3, 2023

      This quality improvement study evaluates low vision rehabilitation service use before and after implementation of an electronic health record–based clinical decision support system at a large ophthalmology department in an academic medical center.

      Ophthalmology Electronic Health Records
      Full Text | pdf link PDF open access
    • Prevalence of Undiagnosed Diabetes Identified by a Novel Electronic Medical Record Diabetes Screening Program in an Urban Emergency Department in the US
      JAMA Network Open
      Research
      January 26, 2023

      This cross-sectional study describes a screening program that was developed to screen for type 2 diabetes in an urban emergency department setting in the US.

      Diabetes and Endocrinology Health Informatics Electronic Health Records Diabetes Emergency Medicine
      Full Text | pdf link PDF open access
    • Development and Validation of Esophageal Squamous Cell Carcinoma Risk Prediction Models Based on an Endoscopic Screening Program
      JAMA Network Open
      Research
      January 26, 2023

      This diagnostic study establishes and validates esophageal squamous cell cancer prediction models for the follow-up stage of esophageal cancer screening and optimization of the esophageal cancer screening program.

      Oncology Surgery Surgical Oncology Gastroenterology and Hepatology Cancer Screening, Prevention, Control
      Full Text | pdf link PDF open access
    • Predictive Accuracy of Stroke Risk Prediction Models Across Black and White Race, Sex, and Age Groups
      JAMA
      Research
      January 24, 2023

      This retrospective cohort study compares stroke-specific algorithms with pooled cohort equations developed for atherosclerotic cardiovascular disease for the prediction of new-onset stroke across different subgroups (race, sex, and age) and the added value of novel machine learning techniques.

      Cerebrovascular Disease Neurology Stroke Cerebrovascular Infarction Health Informatics
      Full Text | pdf link PDF
    • Clinical Algorithms, Antidiscrimination Laws, and Medical Device Regulation
      JAMA
      Opinion
      January 24, 2023

      This Viewpoint discusses recent legal directives by the DHHS and FDA that could increase health care entities’ liability for possible discriminatory biases of clinical algorithms and the need for additional legal clarity to avoid adverse effects on algorithm development and use.

      Regulatory Agencies Health Informatics Equity, Diversity, and Inclusion Law and Medicine
      Full Text | pdf link PDF
    • Prevention of Bias and Discrimination in Clinical Practice Algorithms
      JAMA
      Opinion
      January 24, 2023

      This Viewpoint discusses a proposed DHHS rule to address discrimination in clinical algorithms and the need for additional considerations to ensure the burden of liability for biased algorithms is not disproportionately placed on health care professionals.

      Equity, Diversity, and Inclusion Health Informatics Law and Medicine Health Care Quality
      Full Text | pdf link PDF
    • Nudging to Improve Cardiovascular Care—Clinicians, Patients, or Both
      JAMA Cardiology
      Opinion
      January 1, 2023
      Cardiology Clinical Pharmacy and Pharmacology Dyslipidemia Cardiovascular Risk Factors Health Care Quality
      Full Text | pdf link PDF has multimedia
    • Derivation and Validation of a Clinical Prediction Rule for Upper Limb Functional Outcomes After Traumatic Cervical Spinal Cord Injury
      JAMA Network Open
      Research
      December 21, 2022

      This prognostic study reports the development and validation of a clinical prediction rule that uses the results of a neurological examination to predict upper limb functional outcomes among patients with traumatic cervical spinal cord injury at 1-year follow-up.

      Surgery Neurosurgery Orthopedics Spinal Cord Disorders Neurology
      Full Text | pdf link PDF open access
    • Effect of Computer-Tailored Print Feedback, Motivational Interviewing, and Motivational Enhancement Therapy on Engagement in Advance Care Planning: A Randomized Clinical Trial
      JAMA Internal Medicine
      Research
      December 1, 2022

      This randomized clinical trial examine the efficacy of computer-tailored print feedback (CTPF), motivational interviewing (MI), and motivational enhancement therapy (MET) on completion of a set of advance care planning activities, each as compared with usual care.

      Geriatrics End of Life Shared Decision Making and Communication Veterans Health
      Full Text | pdf link PDF
    • Use of Computed Tomography of the Head in Patients With Acute Atraumatic Altered Mental Status: A Systematic Review and Meta-analysis
      JAMA Network Open
      Research
      November 18, 2022

      This systematic review and meta-analysis assesses the use of noncontrast computed tomography of the head in patients with atraumatic acute-onset altered mental status.

      Neurology Radiology Critical Care Medicine Emergency Medicine
      Full Text | pdf link PDF open access
    • Development and Validation of an Integrated Suite of Prediction Models for All-Cause 30-Day Readmissions of Children and Adolescents Aged 0 to 18 Years
      JAMA Network Open
      Research
      November 11, 2022

      This prognostic study develops pediatric readmission risk tools that use clinical, demographic, and socioeconomic data readily available in the electronic health record and reflect the dynamic trajectory of illness and clinical care throughout the hospital stay among children and adolescents.

      Pediatrics Health Informatics Electronic Health Records Adolescent Medicine
      Full Text | pdf link PDF open access
    • Ensuring High-Quality Shared Decision-making for Lung Cancer Screening
      JAMA Oncology
      Opinion
      November 1, 2022

      This Viewpoint discusses the role of the International Patient Decision Aid Standards Collaboration in emphasizing the importance of shared decision-making facilitated by trained individuals and the use of decision aids that meet minimal quality standards when counseling patients for lung cancer screening.

      Cancer Screening, Prevention, Control Lung Cancer Oncology Shared Decision Making and Communication
      Full Text | pdf link PDF
    • Effect of Electronic Health Record Clinical Decision Support on Contextualization of Care: A Randomized Clinical Trial
      JAMA Network Open
      Research
      October 24, 2022

      This randomized clinical trial assesses the use of clinical decision support tools to provide primary care clinicians with information about contextual factors regarding patient life challenges at the point of care.

      Health Informatics Electronic Health Records
      Full Text | pdf link PDF open access
    • Development of a Pediatric Blood Pressure Percentile Tool for Clinical Decision Support
      JAMA Network Open
      Research
      October 17, 2022

      This diagnostic study assesses the ability of a pediatric blood pressure percentile tool to accelerate identification of children with hypertension and hypotension by clinicians and researchers.

      Pediatrics Health Informatics Hypertension
      Full Text | pdf link PDF open access
    • Association of Disparities in Family History and Family Cancer History in the Electronic Health Record With Sex, Race, Hispanic or Latino Ethnicity, and Language Preference in 2 Large US Health Care Systems
      JAMA Network Open
      Research
      October 4, 2022

      This quality improvement study examines disparities in the availability and comprehensiveness of cancer family history information by sex, race and ethnicity, and language preference in electronic health record data in 2 large US health care systems.

      Health Informatics Health Inequities Oncology Cancer Genetics Health Policy
      Full Text | pdf link PDF open access
    • Improving Antibiotic Stewardship for Diarrheal Disease With Probability-Based Electronic Clinical Decision Support: A Randomized Crossover Trial
      JAMA Pediatrics
      Research
      October 1, 2022

      This study attempts to determine whether the diarrheal etiology prediction algorithm impacts antibiotic prescriptions in patients with acute diarrhea.

      Infectious Diseases Antibiotic Use, Overuse, Resistance, Stewardship Gastroenterology and Hepatology Gastroenterology
      Full Text | pdf link PDF open access
    • Effect of a Decision Aid on Agreement Between Patient Preferences and Repair Type for Abdominal Aortic Aneurysm: A Randomized Clinical Trial
      JAMA Surgery
      Research
      September 14, 2022

      This cluster randomized trial determines the effect of a decision aid on agreement between patient preference for abdominal aortic aneurysm repair type and the repair type they receive.

      Surgery Vascular Surgery
      Full Text | pdf link PDF
    • Open or Endovascular Repair for Abdominal Aortic Aneurysm—Would a Decision Aid Help?
      JAMA Surgery
      Opinion
      September 14, 2022
      Surgery Vascular Surgery
      Full Text | pdf link PDF
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