title: A clinical decision support system for the diagnosis, fracture risks and treatment of osteoporosis.
abstract: Expanding medical knowledge increases the potential risk of medical errors in clinical practice. We present, OPAD, a clinical decision support system in the field of the medical care of osteoporosis. We utilize clinical information from international guidelines and experts in the field of osteoporosis. Physicians are provided with user interface to insert standard patient data, from which OPAD provides instant diagnostic comments, 10-year risk of fragility fracture, treatment options for the given case, and when to offer a follow-up DXA-evaluation. Thus, the medical decision making is standardized according to the best expert knowledge at any given time. OPAD was evaluated in a set of 308 randomly selected individuals. OPAD's ten-year fracture risk computation is nearly identical to FRAX (r = 0.988). In 58% of cases OPAD recommended DXA evaluation at the present time. Following a DXA measurement in all individuals, 71% of those that were recommended to have DXA at the present time received recommendation for further investigation or specific treatment by the OPAD. In only 5.9% of individuals in which DXA was not recommended, the result of the BMD measurement changed the recommendations given by OPAD.
authors: Institute of Biomedical and Neural Engineering, School of Science and Engineering, Reykjavik University, 101 Reykjavik, Iceland.
authors: Bjarni V
authors: BV
authors: Halldorsson
authors: Centre for Rheumatology Research, University Hospital, 101 Reykjavik, Iceland ; Faculty of Medicine, Debrecen University, Debrecen 4032, Hungary.
authors: Aron Hjalti
authors: AH
authors: Bjornsson
authors: Centre for Rheumatology Research, University Hospital, 101 Reykjavik, Iceland ; Faculty of Medicine, University of Iceland, 101 Reykjavik, Iceland.
authors: Haukur Tyr
authors: HT
authors: Gudmundsson
authors: Osteoporosis Clinic, Akureyri Hospital, 600 Akureyri, Iceland.
authors: Elvar Orn
authors: EO
authors: Birgisson
authors: Faculty of Medicine, University of Iceland, 101 Reykjavik, Iceland ; Department of Immunology, University Hospital, 101 Reykjavik, Iceland.
authors: Bjorn Runar
authors: BR
authors: Ludviksson
authors: Centre for Rheumatology Research, University Hospital, 101 Reykjavik, Iceland ; Faculty of Medicine, University of Iceland, 101 Reykjavik, Iceland.
authors: Bjorn
authors: 0000-0003-4631-6505
authors: B
authors: Gudbjornsson
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015519:Bone Density; D000066491:Clinical Decision-Making; D020000:Decision Support Systems, Clinical; D005103:Expert Systems; D005260:Female; D006801:Humans; D008297:Male; D008490:Medical Informatics / Q000379:methods*; D008875:Middle Aged; D010024:Osteoporosis / Q000175:diagnosis* / Q000503:physiopathology / Q000628:therapy*; D058866:Osteoporotic Fractures / Q000175:diagnosis / Q000503:physiopathology; D011336:Probability; D012307:Risk Factors; D012984:Software; D055815:Young Adult