Leveraging electronic medical records to evaluate a computerized decision support system for staphylococcus bacteremia
Abstract Infectious disease specialists (IDS) improve outcomes of patients with Staphylococcus bacteremia, but immediate IDS access is not always guaranteed. We investigated whether a care-integrated computerized decision support system (CDSS) can safely enhance the standard of care (SOC) for these...
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Nature Portfolio
2025-03-01
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| Online Access: | https://doi.org/10.1038/s41746-025-01569-3 |
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| author | Julia Palm Ssuhir Alaid Danny Ammon Julian Brandes Andreas Dürschmid Claudia Fischer Jonas Fortmann Kristin Friebel Sarah Geihs Anne-Kathrin Hartig Donghui He Andrew J. Heidel Petra Hetfeld Roland Ihle Suzanne Kahle Verena Koi Margarethe Konik Frauke Kretzschmann Henner Kruse Norman Lippmann Christoph Lübbert Gernot Marx Rafael Mikolajczyk Anne Mlocek Stefan Moritz Christoph Müller Susanne Müller Ariadna Pérez Garriga Lo An Phan-Vogtmann Diana Pietzner Mathias W. Pletz Mario Popp Maike Rebenstorff Jonas Renz Florian Rißner Rainer Röhrig Kutaiba Saleh Sebastian G. Schönherr Cord Spreckelsen Anja Stempel Abel Stolz Eric Thomas Susanne Thon Daniel Tiller Sebastian Uschmann Sebastian Wendt Thomas Wendt Philipp Winnekens Oliver Witzke Stefan Hagel André Scherag |
| author_facet | Julia Palm Ssuhir Alaid Danny Ammon Julian Brandes Andreas Dürschmid Claudia Fischer Jonas Fortmann Kristin Friebel Sarah Geihs Anne-Kathrin Hartig Donghui He Andrew J. Heidel Petra Hetfeld Roland Ihle Suzanne Kahle Verena Koi Margarethe Konik Frauke Kretzschmann Henner Kruse Norman Lippmann Christoph Lübbert Gernot Marx Rafael Mikolajczyk Anne Mlocek Stefan Moritz Christoph Müller Susanne Müller Ariadna Pérez Garriga Lo An Phan-Vogtmann Diana Pietzner Mathias W. Pletz Mario Popp Maike Rebenstorff Jonas Renz Florian Rißner Rainer Röhrig Kutaiba Saleh Sebastian G. Schönherr Cord Spreckelsen Anja Stempel Abel Stolz Eric Thomas Susanne Thon Daniel Tiller Sebastian Uschmann Sebastian Wendt Thomas Wendt Philipp Winnekens Oliver Witzke Stefan Hagel André Scherag |
| author_sort | Julia Palm |
| collection | DOAJ |
| description | Abstract Infectious disease specialists (IDS) improve outcomes of patients with Staphylococcus bacteremia, but immediate IDS access is not always guaranteed. We investigated whether a care-integrated computerized decision support system (CDSS) can safely enhance the standard of care (SOC) for these patients. We conducted a multicenter, noninferiority, interventional stepped-wedge cluster randomized controlled trial relying on the data integration centers at five university hospitals. By this means, electronic medical records can be used for part of the trial documentation. We analyzed 5056 patients from 134 wards (Staphylococcus aureus (SAB): n = 812, coagulase-negative staphylococci (CoNS): n = 4244) and found that the CDSS was noninferior to the SOC for hospital mortality in all patients. Noninferiority regarding the 90-day mortality/relapse in SAB patients was not observed and there was no evidence for differences in vancomycin usage among CoNS patients. Despite low reported usage, physicians rated the CDSS’s usability favorably. Trial registration: drks.de; Identifier: DRKS00014320; Registration Date: 2019-05-06. |
| format | Article |
| id | doaj-art-4bcc05a1c5ec4cba85c257b79da23b05 |
| institution | OA Journals |
| issn | 2398-6352 |
| language | English |
| publishDate | 2025-03-01 |
| publisher | Nature Portfolio |
| record_format | Article |
| series | npj Digital Medicine |
| spelling | doaj-art-4bcc05a1c5ec4cba85c257b79da23b052025-08-20T02:10:22ZengNature Portfolionpj Digital Medicine2398-63522025-03-01811910.1038/s41746-025-01569-3Leveraging electronic medical records to evaluate a computerized decision support system for staphylococcus bacteremiaJulia Palm0Ssuhir Alaid1Danny Ammon2Julian Brandes3Andreas Dürschmid4Claudia Fischer5Jonas Fortmann6Kristin Friebel7Sarah Geihs8Anne-Kathrin Hartig9Donghui He10Andrew J. Heidel11Petra Hetfeld12Roland Ihle13Suzanne Kahle14Verena Koi15Margarethe Konik16Frauke Kretzschmann17Henner Kruse18Norman Lippmann19Christoph Lübbert20Gernot Marx21Rafael Mikolajczyk22Anne Mlocek23Stefan Moritz24Christoph Müller25Susanne Müller26Ariadna Pérez Garriga27Lo An Phan-Vogtmann28Diana Pietzner29Mathias W. Pletz30Mario Popp31Maike Rebenstorff32Jonas Renz33Florian Rißner34Rainer Röhrig35Kutaiba Saleh36Sebastian G. Schönherr37Cord Spreckelsen38Anja Stempel39Abel Stolz40Eric Thomas41Susanne Thon42Daniel Tiller43Sebastian Uschmann44Sebastian Wendt45Thomas Wendt46Philipp Winnekens47Oliver Witzke48Stefan Hagel49André Scherag50Institute of Medical Statistics, Computer and Data Sciences, Jena University HospitalIT Department, Data Integration Center, University Hospital HalleData Integration Center, Jena University HospitalCenter for Medical Informatics, Data Integration Center, University of Leipzig Medical CenterCenter for Medical Informatics, Data Integration Center, University of Leipzig Medical CenterInstitute of Medical Statistics, Computer and Data Sciences, Jena University HospitalInstitute of Medical Informatics, University Hospital RWTH AachenInstitute of Medical Statistics, Computer and Data Sciences, Jena University HospitalIT Department, Data Integration Center, University Hospital AachenIT Department, Data Integration Center, University Hospital HalleCentral IT Department, Data Integration Center, University Hospital EssenData Integration Center, Jena University HospitalDepartment of Intensive Care Medicine and Intermediate Care, University Hospital RWTH AachenCentral IT Department, Data Integration Center, University Hospital EssenCenter for Medical Informatics, Data Integration Center, University of Leipzig Medical CenterCenter for Medical Informatics, Data Integration Center, University of Leipzig Medical CenterDepartment of Infectious Diseases, West German Centre of Infectious Diseases, University Hospital Essen, University Duisburg-EssenIT Department, Data Integration Center, University Hospital AachenData Integration Center, Jena University HospitalInstitute for Medical Microbiology and Virology, University Hospital LeipzigDivision of Infectious Diseases and Tropical Medicine, Department of Medicine I, University Hospital LeipzigDepartment of Intensive Care Medicine and Intermediate Care, University Hospital RWTH AachenInstitute of Medical Epidemiology, Biometrics, and Informatics, Medical Faculty of the Martin-Luther University Halle-WittenbergInstitute for Medical Microbiology and Virology, University Hospital LeipzigSection of Clinical Infectious Diseases, University Hospital HalleIT Department, Data Integration Center, University Hospital AachenInstitute of Medical Statistics, Computer and Data Sciences, Jena University HospitalInstitute of Medical Informatics, University Hospital RWTH AachenInstitute of Medical Statistics, Computer and Data Sciences, Jena University HospitalIT Department, Data Integration Center, University Hospital HalleInstitute for Infectious Diseases and Infection Control, Jena University Hospital, Friedrich-Schiller-University JenaSection of Clinical Infectious Diseases, University Hospital HalleInstitute for Medical Microbiology and Virology, University Hospital LeipzigData Integration Center, Jena University HospitalCenter for Clinical Studies, Friedrich-Schiller-University JenaInstitute of Medical Informatics, University Hospital RWTH AachenData Integration Center, Jena University HospitalDivision of Infectious Diseases and Tropical Medicine, Department of Medicine I, University Hospital LeipzigInstitute of Medical Statistics, Computer and Data Sciences, Jena University HospitalDepartment of Infectious Diseases, West German Centre of Infectious Diseases, University Hospital Essen, University Duisburg-EssenCenter for Medical Informatics, Data Integration Center, University of Leipzig Medical CenterData Integration Center, Jena University HospitalInstitute of Medical Microbiology, Jena University HospitalIT Department, Data Integration Center, University Hospital HalleInstitute of Medical Statistics, Computer and Data Sciences, Jena University HospitalHospital Hygiene Staff Unit, University Hospital Halle (Saale)Center for Medical Informatics, Data Integration Center, University of Leipzig Medical CenterCentral IT Department, Data Integration Center, University Hospital EssenDepartment of Infectious Diseases, West German Centre of Infectious Diseases, University Hospital Essen, University Duisburg-EssenInstitute for Infectious Diseases and Infection Control, Jena University Hospital, Friedrich-Schiller-University JenaInstitute of Medical Statistics, Computer and Data Sciences, Jena University HospitalAbstract Infectious disease specialists (IDS) improve outcomes of patients with Staphylococcus bacteremia, but immediate IDS access is not always guaranteed. We investigated whether a care-integrated computerized decision support system (CDSS) can safely enhance the standard of care (SOC) for these patients. We conducted a multicenter, noninferiority, interventional stepped-wedge cluster randomized controlled trial relying on the data integration centers at five university hospitals. By this means, electronic medical records can be used for part of the trial documentation. We analyzed 5056 patients from 134 wards (Staphylococcus aureus (SAB): n = 812, coagulase-negative staphylococci (CoNS): n = 4244) and found that the CDSS was noninferior to the SOC for hospital mortality in all patients. Noninferiority regarding the 90-day mortality/relapse in SAB patients was not observed and there was no evidence for differences in vancomycin usage among CoNS patients. Despite low reported usage, physicians rated the CDSS’s usability favorably. Trial registration: drks.de; Identifier: DRKS00014320; Registration Date: 2019-05-06.https://doi.org/10.1038/s41746-025-01569-3 |
| spellingShingle | Julia Palm Ssuhir Alaid Danny Ammon Julian Brandes Andreas Dürschmid Claudia Fischer Jonas Fortmann Kristin Friebel Sarah Geihs Anne-Kathrin Hartig Donghui He Andrew J. Heidel Petra Hetfeld Roland Ihle Suzanne Kahle Verena Koi Margarethe Konik Frauke Kretzschmann Henner Kruse Norman Lippmann Christoph Lübbert Gernot Marx Rafael Mikolajczyk Anne Mlocek Stefan Moritz Christoph Müller Susanne Müller Ariadna Pérez Garriga Lo An Phan-Vogtmann Diana Pietzner Mathias W. Pletz Mario Popp Maike Rebenstorff Jonas Renz Florian Rißner Rainer Röhrig Kutaiba Saleh Sebastian G. Schönherr Cord Spreckelsen Anja Stempel Abel Stolz Eric Thomas Susanne Thon Daniel Tiller Sebastian Uschmann Sebastian Wendt Thomas Wendt Philipp Winnekens Oliver Witzke Stefan Hagel André Scherag Leveraging electronic medical records to evaluate a computerized decision support system for staphylococcus bacteremia npj Digital Medicine |
| title | Leveraging electronic medical records to evaluate a computerized decision support system for staphylococcus bacteremia |
| title_full | Leveraging electronic medical records to evaluate a computerized decision support system for staphylococcus bacteremia |
| title_fullStr | Leveraging electronic medical records to evaluate a computerized decision support system for staphylococcus bacteremia |
| title_full_unstemmed | Leveraging electronic medical records to evaluate a computerized decision support system for staphylococcus bacteremia |
| title_short | Leveraging electronic medical records to evaluate a computerized decision support system for staphylococcus bacteremia |
| title_sort | leveraging electronic medical records to evaluate a computerized decision support system for staphylococcus bacteremia |
| url | https://doi.org/10.1038/s41746-025-01569-3 |
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