Cardiovascular Disease Prevention: Clinical Decision-Support Systems (CDSS)

Clinical decision-support systems (CDSS) are computer-based information systems designed to assist healthcare providers in implementing clinical guidelines at the point of care. CDSS use patient data to provide tailored patient assessments and evidence-based treatment recommendations for healthcare providers to consider. Patient information is entered manually or automatically through an electronic health record (EHR) system. CDSS for cardiovascular disease prevention (CVD) include one or more of the following.

Reminders for overdue CVD preventive services including screening for CVD risk factors such as high blood pressure, diabetes, and high cholesterol

Assessments of patients' risk for developing CVD based on their history, symptoms, and clinical test results

Recommendations for evidence-based treatments to prevent CVD, including intensification of treatment

Recommendations for health behavior changes to discuss with patients such as quitting smoking, increasing physical activity, and reducing excessive salt intake

Alerts when indicators for CVD risk factors are not at goal

CDSS are often incorporated within EHR systems and integrated with other computer-based functions that offer patient-care summary reports, feedback on quality indicators, and benchmarking. Knowledge management systems providing access to scientific literature and strategies for CVD prevention may also be linked with CDSS.

Summary of Task Force Recommendations & Findings

The Community Preventive Services Task Force recommends clinical decision-support systems (CDSS) for prevention of cardiovascular disease (CVD) based on sufficient evidence of effectiveness in improving screening for CVD risk factors and practices for CVD-related preventive care services, clinical tests, and treatments.
Most of the available evidence is from studies on the effectiveness of CDSS when implemented alone in the healthcare system rather than as part of a coordinated service delivery effort to address barriers at the patient, provider, organizational, and community levels. More evidence is needed from implementation of CDSS as one part of a comprehensive service delivery system designed to improve outcomes for CVD risk factors and reduce CVD-related morbidity and mortality.
Task Force Finding and Rationale Statement

The Task Force finding presented on this page was made in April 2013. It is based on evidence from 44 studies evaluating the effectiveness of CDSS for CVD prevention. The studies were identified from a broad systematic review (Bright et al. 2012, search period January 1976-January 2011) that examined the effectiveness of CDSS in improving quality of care and clinical outcomes for a variety of conditions (e.g., CVD prevention, cancer screening, immunization, antenatal care) and an updated search for newer CVD prevention-focused studies (search period January 2011- October 2012).
The review was conducted on behalf of the Task Force by a team of specialists in systematic review methods, and in research, practice and policy related to cardiovascular disease prevention and control. Subscribe to be notified as new materials on this topic become available.

Publications

The findings and results of this systematic review have not been published. You may subscribe to be notified as new materials on this topic become available.

References

Bright TJ, Wong A, Dhurjati R, Bristow E, Bastian L, et al. Effect of clinical decision-support systems: a systematic review. Ann Intern Med 2012;157(1):29-43.

Disclaimer

The findings and conclusions on this page are those of the Community Preventive Services Task Force and do not necessarily represent those of CDC.

Sample Citation

The content of publications of the Guide to Community Preventive Services is in the public domain. Citation as to source, however, is appreciated. Sample citation: Guide to Community Preventive Services. . Cardiovascular disease prevention and control: clinical decision-support systems (CDSS). www.thecommunityguide.org/cvd/CDSS.html. Last updated: MM/DD/YYYY.
Review Completed: April 2013