2025
Case Report: A health system’s experience using clinical decision support to promote note sharing after the 21st Century Cures Act
Iscoe M, Venkatesh A, Powers E, Kashyap N, Hsiao A, Millard H, Sangal R. Case Report: A health system’s experience using clinical decision support to promote note sharing after the 21st Century Cures Act. JAMIA Open 2025, 8: ooaf051. PMID: 40510806, PMCID: PMC12161449, DOI: 10.1093/jamiaopen/ooaf051.Peer-Reviewed Original ResearchClinical decision supportHealth system's experienceRegional health systemDecision supportPatient engagementCentury Cures ActHealth systemPortal accessClinical notesConsistent with prior research showingCures ActPromote complianceSensitive informationStudy periodLinear regressionPediatricObservational analysisPsychiatryPatients/proxiesNotesPatientsSupportHealthCliniciansResearch showAutomated computation of the HEART score with the GPT-4 large language model
Wright D, Socrates V, Huang T, Safranek C, Sangal R, Dilip M, Boivin Z, Srica N, Wright C, Feher A, Miller E, Chartash D, Taylor R. Automated computation of the HEART score with the GPT-4 large language model. The American Journal Of Emergency Medicine 2025, 93: 120-125. PMID: 40184662, PMCID: PMC12202168, DOI: 10.1016/j.ajem.2025.03.065.Peer-Reviewed Original ResearchConceptsClinical decision supportHEART scoreChest pain observation unitAverage heart scoreCohen's weighted kappaDecision supportNurse practitionersPhysician assistantsRetrospective cohort studyRoutine careCases of disagreementProspective InvestigationAPP scoresCohort studySafety interventionsPhysician judgmentObservation unitAdverse cardiac eventsInstitutional registryScoresPhysiciansInterventionParticipantsNo significant differenceAppsElectronic health record nudges to optimize guideline-directed medical therapy for heart failure
Fuery M, Clark K, Sikand N, Tabtabai S, Sen S, Wilson F, Desai N, Ahmad T, Samsky M. Electronic health record nudges to optimize guideline-directed medical therapy for heart failure. Heart Failure Reviews 2025, 30: 771-776. PMID: 40106122, DOI: 10.1007/s10741-025-10503-4.Peer-Reviewed Original ResearchConceptsElectronic health recordsClinical decision supportGuideline-directed medical therapyPotential of electronic health recordsElectronic health record systemsDiverse healthcare settingsGDMT adherenceCare qualityClinician workflowHealth recordsAlert contentHF careHealthcare settingsPatient careInformed treatment decisionsTargeted alertingQuality gapEnhanced usabilityImprove heart failureHeart failureDecision supportReal-timeCareTreatment decisionsAlerting strategyA mixed-methods study assessing the performance of a clinical decision support tool for Clostridioides difficile testing for patients receiving laxatives
Peaper D, Rathod S, Sussman L, Azar M, Murdzek C, Roberts S, Tichy E, Topal J, Kashyap N, McManus D, Martinello R. A mixed-methods study assessing the performance of a clinical decision support tool for Clostridioides difficile testing for patients receiving laxatives. Infection Control And Hospital Epidemiology 2025, 46: 497-503. PMID: 40079209, PMCID: PMC12034449, DOI: 10.1017/ice.2025.30.Peer-Reviewed Original ResearchClinical decision supportAdvanced practice providersClinical decision support alertsClinical decision support toolMixed-methods studyPractice providersClinician interactionClinician concernsPhysician's instructionsTest orderingAttending physiciansMixed-methodsDoses of laxativesPatient riskLaxative useClinicians' rationaleCliniciansDecision support toolHospitalized patientsStudy periodDecision supportAttendanceCase seriesAntibiotic exposureResidentsAdaptive decision support for addiction treatment to implement initiation of buprenorphine for opioid use disorder in the emergency department: protocol for the ADAPT Multiphase Optimization Strategy trial
Iscoe M, Hooper C, Levy D, Buchanan L, Dziura J, Meeker D, Taylor R, D’Onofrio G, Oladele C, Sarpong D, Paek H, Wilson F, Heagerty P, Delgado M, Hoppe J, Melnick E. Adaptive decision support for addiction treatment to implement initiation of buprenorphine for opioid use disorder in the emergency department: protocol for the ADAPT Multiphase Optimization Strategy trial. BMJ Open 2025, 15: e098072. PMID: 39979056, PMCID: PMC11842997, DOI: 10.1136/bmjopen-2024-098072.Peer-Reviewed Original ResearchConceptsClinical decision supportMultiphase optimization strategyOpioid use disorderEmergency departmentInitiation of buprenorphineClinical decision support usePlan-Do-Study-Act cyclesLearning health system approachPlan-Do-Study-ActClinical decision support toolHealth system approachAdaptive decision supportUse disorderDecision supportAddiction treatmentPeer-reviewed journalsBuprenorphine initiationOpioid use disorder treatment initiationOpioid-related mortalityIntervention componentsED settingClinician feedbackInstitute Institutional Review BoardTreatment of opioid use disorderParticipating sitesPalliative Care Initiated in the Emergency Department
Grudzen C, Siman N, Cuthel A, Adeyemi O, Yamarik R, Goldfeld K, Abella B, Bellolio F, Bourenane S, Brody A, Cameron-Comasco L, Chodosh J, Cooper J, Deutsch A, Elie M, Elsayem A, Fernandez R, Fleischer-Black J, Gang M, Genes N, Goett R, Heaton H, Hill J, Horwitz L, Isaacs E, Jubanyik K, Lamba S, Lawrence K, Lin M, Loprinzi-Brauer C, Madsen T, Miller J, Modrek A, Otero R, Ouchi K, Richardson C, Richardson L, Ryan M, Schoenfeld E, Shaw M, Shreves A, Southerland L, Tan A, Uspal J, Venkat A, Walker L, Wittman I, Zimny E. Palliative Care Initiated in the Emergency Department. JAMA 2025, 333: 599-608. PMID: 39813042, PMCID: PMC11836764, DOI: 10.1001/jama.2024.23696.Peer-Reviewed Original ResearchConceptsInitiate palliative careLife-limiting illnessHealth care usePalliative carePostintervention periodPreintervention periodMulticomponent interventionCare useEmergency departmentOlder adultsHospital admissionRates of hospice useShort-term mortalitySecondary outcomesRate of hospital admissionsED clinical staffHome health useClinical decision supportNursing home patientsSimulation-based workshopGagne comorbidity scoreRate of admissionRisk of short-term mortalityHospice useIllness communicationEfficacy of a Clinical Decision Support Tool to Promote Guideline-Concordant Evaluations in Patients With High-Risk Microscopic Hematuria: A Cluster Randomized Quality Improvement Project
Matulewicz R, Tsuruo S, King W, Nagler A, Feuer Z, Szerencsy A, Makarov D, Wong C, Dapkins I, Horwitz L, Blecker S. Efficacy of a Clinical Decision Support Tool to Promote Guideline-Concordant Evaluations in Patients With High-Risk Microscopic Hematuria: A Cluster Randomized Quality Improvement Project. Journal Of Urology 2025, 213: 558-567. PMID: 39854625, DOI: 10.1097/ju.0000000000004436.Peer-Reviewed Original ResearchClinical decision supportQuality improvement projectIntervention armImprovement projectImplementation of clinical decision supportClinical decision support alertsMultisite academic medical centerClinical decision support toolPrimary outcomeElectronic health recordsBarriers to evaluationAcademic medical centerHigh riskCDS alertsCDS toolsUsual careHealth recordsHealth systemPatient completionGuideline-concordantAmbulatory sitesImaging ordersCompletion of imagingControl armPromotion evaluation
2024
Leveraging artificial intelligence to reduce diagnostic errors in emergency medicine: Challenges, opportunities, and future directions
Taylor R, Sangal R, Smith M, Haimovich A, Rodman A, Iscoe M, Pavuluri S, Rose C, Janke A, Wright D, Socrates V, Declan A. Leveraging artificial intelligence to reduce diagnostic errors in emergency medicine: Challenges, opportunities, and future directions. Academic Emergency Medicine 2024, 32: 327-339. PMID: 39676165, PMCID: PMC11921089, DOI: 10.1111/acem.15066.Peer-Reviewed Original ResearchClinical decision supportEmergency departmentArtificial intelligencePatient safetyDiagnostic errorsImplementing AIImprove patient safetyClinical decision support systemsEnhance patient outcomesReducing diagnostic errorsLeverage artificial intelligenceEmergency medicineHealth careTargeted educationReduce cognitive loadQuality improvementEmergency cliniciansData retrievalReal-time insightsDecision supportPatient outcomesCognitive overloadInformation-gathering processPatient detailsCliniciansIndividual and System-level Factors Contributing to Guideline Nonadherent Surgical Antibiotic Prophylaxis at a Tertiary Healthcare System: A Qualitative Analysis
Bardia A, Melnick E, McCall T, Zhao X, Lin H, Fisher C, Burg M, Schonberger R. Individual and System-level Factors Contributing to Guideline Nonadherent Surgical Antibiotic Prophylaxis at a Tertiary Healthcare System: A Qualitative Analysis. Anesthesiology 2024, 142: 489-499. PMID: 39556527, PMCID: PMC11813683, DOI: 10.1097/aln.0000000000005302.Peer-Reviewed Original ResearchClinical decision supportCertified Registered Nurse AnesthetistsGuideline adherenceInfectious Diseases Society of AmericaQualitative studyTertiary health care systemClinical decision support toolSemi-structured interview formatSystem-level factorsHealth care systemRegistered Nurse AnesthetistsConstant comparison methodInfectious Diseases SocietyDecision supportAntibiotic guidelinesCare systemProvider needsNurse anesthetistsPerioperative pharmacistLimited familiarityPerceived benefitsNon-adherenceInterview formatLevel factorsResident traineesPatient-Centered and Practical Privacy to Support AI for Healthcare
Liu R, Lee H, Bhavani S, Jiang X, Ohno-Machado L, Xiong L. Patient-Centered and Practical Privacy to Support AI for Healthcare. 2024, 00: 265-272. DOI: 10.1109/tps-isa62245.2024.00038.Peer-Reviewed Original ResearchDifferential privacyArtificial intelligenceState-of-the-art approachesPrivacy-sensitive domainsState-of-the-artSensitive patient informationIntegration of artificial intelligenceClinical decision supportPrivacy requirementsPrivacy guaranteesPrivacy solutionsPractical privacyPotential research directionsPrivacy concernsVision paperPrivacy needsAI systemsAI modelsPrivacyDecision supportResearch directionsPatient informationTrade-OffsModel's utilityPrediction modelRelation extraction using large language models: a case study on acupuncture point locations
Li Y, Peng X, Li J, Zuo X, Peng S, Pei D, Tao C, Xu H, Hong N. Relation extraction using large language models: a case study on acupuncture point locations. Journal Of The American Medical Informatics Association 2024, 31: 2622-2631. PMID: 39208311, PMCID: PMC11491641, DOI: 10.1093/jamia/ocae233.Peer-Reviewed Original ResearchAcupuncture point locationsAcupoint locationLocation of acupointsClinical decision supportAcupuncture knowledgeAcupuncture trainingAcupuncture therapyAcupunctureAcupointsComplementary medicineEducational moduleWestern Pacific RegionInformatics applicationsDecision supportScoresGenerative Pre-trained TransformerWHO standardsF1 scoreLanguage modelPacific regionWHODomain-specific fine-tuningTrainingStudyMicro-averaged F1 scoreAn LLM's Medical Testing Recommendations in a Nigerian Clinic: Potential and Limits of Prompt Engineering for Clinical Decision Support
McPeak G, Sautmann A, George O, Hallal A, Simal E, Schwartz A, Abaluck J, Ravi N, Pless R. An LLM's Medical Testing Recommendations in a Nigerian Clinic: Potential and Limits of Prompt Engineering for Clinical Decision Support. 2024, 00: 586-591. DOI: 10.1109/ichi61247.2024.00094.Peer-Reviewed Original ResearchMultiscale Neuroimaging Features for the Identification of Medication Class and Non-Responders in Mood Disorder Treatment
Baker B, Salman M, Fu Z, Iraji A, Osuch E, Bockholt H, Calhoun V. Multiscale Neuroimaging Features for the Identification of Medication Class and Non-Responders in Mood Disorder Treatment. 2024, 00: 1-5. DOI: 10.1109/isbi56570.2024.10635741.Peer-Reviewed Original ResearchTreatment of mood disordersMood disordersCourse of antidepressantsFunctional network connectivity measuresMedication classesMood disorder treatmentNeuroimaging featuresComplex behavioral symptomsNetwork connectivity measuresMood stabilizersNon-respondersBehavioral symptomsDisorder treatmentNeuroimaging scansResting state functional networksNeural featuresConnectivity measuresFunctional networksMoodDisordersEffective courseAntidepressantsClinical decision supportClinical treatmentSymptomsSystematic review: The use of large language models as medical chatbots in digestive diseases
Giuffrè M, Kresevic S, You K, Dupont J, Huebner J, Grimshaw A, Shung D. Systematic review: The use of large language models as medical chatbots in digestive diseases. Alimentary Pharmacology & Therapeutics 2024, 60: 144-166. PMID: 38798194, DOI: 10.1111/apt.18058.Peer-Reviewed Original ResearchLanguage modelAdverse patient safety eventsPatient safety eventsClinical decision supportRisk of biasSystematic literature searchWeb of Science Core CollectionCombination of keywordsMedical chatbotTriage recommendationsHealthcare systemScience Core CollectionNecessary careSafety eventsOverburden healthcare systemsMedical adviceOvid MEDLINEMultiple specialtiesDecision supportOvid EmbaseCochrane LibrarySingle-study resultsGoogle ScholarLiterature searchGastroenterologyUser-Centered Framework for Implementation of Technology (UFIT): Development of an Integrated Framework for Designing Clinical Decision Support Tools Packaged With Tailored Implementation Strategies
Ray J, Finn E, Tyrrell H, Aloe C, Perrin E, Wood C, Miner D, Grout R, Michel J, Damschroder L, Sharifi M. User-Centered Framework for Implementation of Technology (UFIT): Development of an Integrated Framework for Designing Clinical Decision Support Tools Packaged With Tailored Implementation Strategies. Journal Of Medical Internet Research 2024, 26: e51952. PMID: 38771622, PMCID: PMC11150893, DOI: 10.2196/51952.Peer-Reviewed Original ResearchConceptsClinical decision supportPrimary care cliniciansUser-centered designImplementation strategiesUser-centered frameworkCare cliniciansImplementation scienceElectronic health record-based clinical decision supportImpact of clinical decision supportImplement clinical decision supportEvidence-based CDSPediatric primary care cliniciansTailored implementation strategiesElectronic health recordsAdoption of evidenceWell-child visitsDecision supportDiverse group of stakeholdersObesity practicePrimary carePediatric overweightHealth recordsHealth systemSemistructured interviewsOverweight treatmentIdentifying signs and symptoms of urinary tract infection from emergency department clinical notes using large language models
Iscoe M, Socrates V, Gilson A, Chi L, Li H, Huang T, Kearns T, Perkins R, Khandjian L, Taylor R. Identifying signs and symptoms of urinary tract infection from emergency department clinical notes using large language models. Academic Emergency Medicine 2024, 31: 599-610. PMID: 38567658, DOI: 10.1111/acem.14883.Peer-Reviewed Original ResearchElectronic health recordsNatural language processingNatural language processing modelsEmergency departmentTransformer-based modelsClinical notesF1-measureClinical decision supportLanguage modelSpaCy modelsU.S. health systemElements of natural language processingPublic health surveillanceConvolutional neural network-based modelProcessing long documentsIdentification of symptomsHealth recordsHealth systemClinician notesNeural network-based modelMedical careHealth surveillanceSymptom identificationEntity recognitionNetwork-based modelAlgorithms in medical decision-making and in everyday life: what’s the difference?
Chartash D, Bruno M. Algorithms in medical decision-making and in everyday life: what’s the difference? Diagnosis 2024, 11: 244-249. PMID: 38386866, DOI: 10.1515/dx-2024-0010.Peer-Reviewed Original ResearchFormative evaluation of an emergency department clinical decision support system for agitation symptoms: a study protocol
Wong A, Nath B, Shah D, Kumar A, Brinker M, Faustino I, Boyce M, Dziura J, Heckmann R, Yonkers K, Bernstein S, Adapa K, Taylor R, Ovchinnikova P, McCall T, Melnick E. Formative evaluation of an emergency department clinical decision support system for agitation symptoms: a study protocol. BMJ Open 2024, 14: e082834. PMID: 38373857, PMCID: PMC10882402, DOI: 10.1136/bmjopen-2023-082834.Peer-Reviewed Original ResearchConceptsComputerised clinical decision supportED treatRestraint useExperiences of restraint useMental health-related visitsEmergency departmentPrevent agitationSystems-related factorsImprove patient experienceClinical decision support systemsRegional health systemClinical decision supportDe-escalation techniquesRandomised controlled trialsFormative evaluationPeer-reviewed journalsBest-practice guidanceAt-risk populationsCDS toolsThematic saturationED cliniciansPatient experienceED sitesHealth systemED physiciansAssociation of collaborative care intervention features with depression and metabolic outcomes in the INDEPENDENT study: A mixed methods study
Hassan S, Liu S, Johnson L, Patel S, Emmert-Fees K, Suvada K, Tandon N, Sridhar G, Aravind S, Poongothai S, Anjana R, Mohan V, Chwastiak L, Ali M. Association of collaborative care intervention features with depression and metabolic outcomes in the INDEPENDENT study: A mixed methods study. Primary Care Diabetes 2024, 18: 319-326. PMID: 38360505, PMCID: PMC11127790, DOI: 10.1016/j.pcd.2024.02.001.Peer-Reviewed Original ResearchClinical decision supportIntervention featuresElectronic clinical decision supportCollaborative care modelPatient-level factorsMixed methods studyCost-effective interventionIntegrated depressionCare modelCare teamAssociated with improvementsLack of associationIntervention successJoint displaysClinical contactMethods studyDepression measuresQualitative findingsPrimary outcomeQualitative dataDepressionInterventionDiabetes treatmentPost Hoc AnalysisVisit frequency
2023
Retrospective evaluation of clinical decision support for within-laboratory optimization of SARS-CoV-2 NAAT workflow
Durant T, Peaper D. Retrospective evaluation of clinical decision support for within-laboratory optimization of SARS-CoV-2 NAAT workflow. Journal Of Clinical Microbiology 2023, 62: e00785-23. PMID: 38132702, PMCID: PMC10865785, DOI: 10.1128/jcm.00785-23.Peer-Reviewed Original Research
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