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Comment & Response
October 13, 2015

Clinical Decision Support Systems and Advanced Diagnostic Imaging—Reply

Author Affiliations
  • 1RAND, Boston, Massachusetts
  • 2RAND-University of California, Los Angeles
JAMA. 2015;314(14):1519. doi:10.1001/jama.2015.10922

In Reply In the demonstration we evaluated, the CDS systems did not access the entire patient record in a readily computable format. Rather, ordering clinicians entered data describing the reason each test was ordered into the CDS system. The systems varied regarding the inclusion of data pertinent to demographics, past medical history, prior imaging or other studies, symptom characterization, and social status.

The ability of the CDS systems to link to and rate orders was highly dependent on the completeness and quality of the data entered. Although the demonstration used several data entry methods, all of the systems studied used top-down methods of capturing structured data, and all showed a substantial proportion of orders could not be rated.