Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2005:2005:41-5.

Data quality in the outpatient setting: impact on clinical decision support systems

Eta S Berner  1 , Ramkumar K Kasiraman, Feliciano Yu, Midge N Ray, Thomas K Houston
Affiliations

Data quality in the outpatient setting: impact on clinical decision support systems

Eta S Berner et al. AMIA Annu Symp Proc. 2005.

Abstract

Clinical decision support system (CDSS) performance may vary with the quality of the input data. We assessed the impact of medical record completeness and accuracy on a CDSS that provides risk assessment for gastrointestinal bleeding and recommends therapy when prescribing NSAIDs. We examined the documentation of six data elements in the medical record and the impact on the performance of the CDSS. We reviewed 178 transcribed clinical encounters from standardized patients with predefined clinical histories. Results showed that the mean completeness score across all encounters was .34. The mean correctness score for those elements present was .94. When the available data was input into the CDSS, the missing data elements resulted in inappropriate and unsafe recommendations in almost 77% of the encounters. The results show that important gaps in the medical record can affect the accuracy of a CDSS designed to improve safe prescribing.

PubMed Disclaimer

References

    1. Pestotnik SL, Classen DC, Evans RS, Burke JP. Implementing Antibiotic Practice Guidelines through Computer-Assisted Decision Support: Clinical and Financial Outcomes. Ann Intern Med. 1996;124:884–90. - PubMed
    1. Bates DW, Gawande AA. Improving safety with information technology. N Engl J Med. 2003;348:2526–34. - PubMed
    1. Garg AX, Adhikari NKJ, McDonald H, et al. Effects of Computerized clinical decision support systems on physician performance and patient outcomes. JAMA. 2005;293:1339–46. - PubMed
    1. Hogan WR, Wagner MM. Accuracy of data in computer-based patient records. J Am Med Inform Assoc. 1997;4:342–55. - PMC - PubMed
    1. Aronsky D, Haug PJ. Assessing the quality of clinical data in a computer-based record for calculating the pneumonia severity index. J Am Med Inform Assoc. 2000;7:55–65. - PMC - PubMed

Publication types

MeSH terms

Substances

LinkOut - more resources