A Pilot Study of a Computerized Decision Support System to Detect Invasive Fungal Infection in Pediatric Hematology/Oncology Patients.
OBJECTIVE
Computerized decision support systems (CDSSs) can provide indication-specific antimicrobial recommendations and approvals as part of hospital antimicrobial stewardship (AMS) programs. The aim of this study was to assess the performance of a CDSS for surveillance of invasive fungal infections (IFIs) in an inpatient hematology/oncology cohort.


METHODS
Between November 1, 2012, and October 31, 2013, pediatric hematology/oncology inpatients diagnosed with an IFI were identified through an audit of the CDSS and confirmed by medical record review. The results were compared to hospital diagnostic-related group (DRG) coding for IFI throughout the same period.


RESULTS
A total of 83 patients were prescribed systemic antifungals according to the CDSS for the 12-month period. The CDSS correctly identified 19 patients with IFI on medical record review, compared with 10 patients identified by DRG coding, of whom 9 were confirmed to have IFI on medical record review.


CONCLUSIONS
CDSS was superior to diagnostic coding in detecting IFI in an inpatient pediatric hematology/oncology cohort. The functionality of CDSS lends itself to inpatient infectious diseases surveillance but depends on prescriber adherence.
1Department of Immunology and Infectious Diseases,Sydney Children's Hospital,Randwick,NSW,Australia.
Adam
A
Bartlett
1Department of Immunology and Infectious Diseases,Sydney Children's Hospital,Randwick,NSW,Australia.
Emma
E
Goeman
2School of Women's and Children's Health,University of New South Wales,Sydney,NSW,Australia.
Aditi
A
Vedi
4University of Technology,Sydney,Australia.
Mona
M
Mostaghim
3Kids Cancer Centre,Sydney Children's Hospital,Randwick,NSW,Australia.
Toby
T
Trahair
3Kids Cancer Centre,Sydney Children's Hospital,Randwick,NSW,Australia.
Tracey A
TA
O'Brien
1Department of Immunology and Infectious Diseases,Sydney Children's Hospital,Randwick,NSW,Australia.
Pamela
P
Palasanthiran
1Department of Immunology and Infectious Diseases,Sydney Children's Hospital,Randwick,NSW,Australia.
Brendan
B
McMullan
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D059019:Clinical Coding; D003201:Computers; D020000:Decision Support Systems, Clinical / Q000295:instrumentation*; D003953:Diagnosis-Related Groups / Q000592:standards*; D005260:Female; D006405:Hematology; D006801:Humans; D007223:Infant; D008297:Male; D008495:Medical Oncology; D009181:Mycoses / Q000175:diagnosis*; D010865:Pilot Projects; D062606:Tertiary Care Centers