Clinical decision support systems for the practice of evidence-based medicine.
BACKGROUND
The use of clinical decision support systems to facilitate the practice of evidence-based medicine promises to substantially improve health care quality.


OBJECTIVE
To describe, on the basis of the proceedings of the Evidence and Decision Support track at the 2000 AMIA Spring Symposium, the research and policy challenges for capturing research and practice-based evidence in machine-interpretable repositories, and to present recommendations for accelerating the development and adoption of clinical decision support systems for evidence-based medicine.


RESULTS
The recommendations fall into five broad areas--capture literature-based and practice-based evidence in machine--interpretable knowledge bases; develop maintainable technical and methodological foundations for computer-based decision support; evaluate the clinical effects and costs of clinical decision support systems and the ways clinical decision support systems affect and are affected by professional and organizational practices; identify and disseminate best practices for work flow-sensitive implementations of clinical decision support systems; and establish public policies that provide incentives for implementing clinical decision support systems to improve health care quality.


CONCLUSIONS
Although the promise of clinical decision support system-facilitated evidence-based medicine is strong, substantial work remains to be done to realize the potential benefits.
Sim
I
I
Department of Medicine, University of California-San Francisco, California 94143-0320, USA. sim@medicine.ucsf.edu
Gorman
P
P
Greenes
R A
RA
Haynes
R B
RB
Kaplan
B
B
Lehmann
H
H
Tang
P C
PC
D020000:Decision Support Systems, Clinical; D003661:Decision Support Techniques; D019317:Evidence-Based Medicine / Q000379:methods*; D006801:Humans; D016347:Medical Records Systems, Computerized; D017410:Practice Guidelines as Topic