Randomized Trial of a Clinical Decision Support System
1. Randomized Trial of a Clinical Decision Support System:
Impact on the Management of Children with Fever
without Apparent Source
JOLT ROUKEMA, MD, PHD, EWOUT W. STEYERBERG, PHD, JOHAN VAN DER LEI, MD, PHD,
HENRIËTTE A. MOLL, MD, PHD
J Am Med Inform Assoc. 2008;15:107–113.
Speaker : Yen-Chih Huang
Advisor : Yu-Chuan Li
2. Introduction
Fever Without apparent Source (FWS)
- body temperature ≧ 38.0 degrees Celsius
- no apparent source found after evaluation
Serious Bacterial Infection (SBI)
1 – 36 months
Sophia Children’s Hospital ( 2003.9.1 – 2005.12.31 )
Time spent at the ED
Identified SBI
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15. Conclusion
Time constraints
ED nurses were aware the decision rule
FWS registration rate is relatively high
Laboratory tests affected diagnostic testing
The prediction rules need adjustment
Reduce false high-risk
Increasing the risk-score threshold
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