title: The Effects of Clinical Decision Support Systems on Medication Safety: An Overview.
abstract: BACKGROUND
  The clinical decision support system(CDSS) has potential to improving medication safety. However, the effects of the intervention were conflicting and uncertain. Meanwhile, the reporting and methodological quality of this field were unknown.
  
  
  OBJECTIVE
  The aim of this overview is to evaluate the effects of CDSS on medication safety and to examine the methodological and reporting quality.
  
  
  METHODS
  PubMed, Embase and Cochrane Library were searched to August 2015. Systematic reviews (SRs) investigating the effects of CDSS on medication safety were included. Outcomes were determined in advance and assessed separately for process of care and patient outcomes. The methodological quality was assessed by Assessment of Multiple Systematic Reviews (AMSTAR) and the reporting quality was examined by Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA).
  
  
  RESULTS
  Twenty systematic reviews, consisting of 237 unique randomized controlled trials(RCTs) and 176 non-RCTs were included. Evidence that CDSS significantly impacted process of care was found in 108 out of 143 unique studies of the 16 SRs examining this effect (75%). Only 18 out of 90 unique studies of the 13 SRs reported significantly evidence that CDSS positively impacted patient outcomes (20%). Ratings for the overall scores of AMSTAR resulted in a mean score of 8.3 with a range of scores from 7.5 to 10.5. The reporting quality was varied. Some contents were particularly strong. However, some contents were poor.
  
  
  CONCLUSIONS
  CDSS reduces medication error by obviously improving process of care and inconsistently improving patient outcomes. Larger samples and longer-term studies are required to ensure more reliable evidence base on the effects of CDSS on patient outcomes. The methodological and reporting quality were varied and some realms need to be improved.
authors.affiliation: Chinese Evidence-based Medicine Centre, West China Hospital, Sichuan University, Chengdu, PR, China.
authors.forename: Pengli
authors.initials: P
authors.lastname: Jia
authors.affiliation: Chinese Evidence-based Medicine Centre, West China Hospital, Sichuan University, Chengdu, PR, China.
authors.forename: Longhao
authors.initials: L
authors.lastname: Zhang
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, The First Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, PR, China.
authors.forename: Jingjing
authors.initials: J
authors.lastname: Chen
authors.affiliation: Chinese Evidence-based Medicine Centre, West China Hospital, Sichuan University, Chengdu, PR, China.
authors.forename: Pujing
authors.initials: P
authors.lastname: Zhao
authors.affiliation: Chinese Evidence-based Medicine Centre, West China Hospital, Sichuan University, Chengdu, PR, China.
authors.forename: Mingming
authors.initials: M
authors.lastname: Zhang
mesh_terms: D020000:Decision Support Systems, Clinical; D006801:Humans; D008508:Medication Errors / Q000517:prevention & control*; D008509:Medication Systems; D061214:Patient Safety / Q000592:standards