Julia Palm, Ssuhir Alaid, Danny Ammon, Julian Brandes, Andreas Dürschmid, Claudia Fischer, Jonas Fortmann, Kristin Friebel, Sarah Geihs, Anne-Kathrin Hartig, Donghui He, Andrew J. Heidel, Petra Hetfeld, Roland Ihle, Suzanne Kahle, Verena Koi, Margarethe Konik, Frauke Kretzschmann, Henner Kruse, Norman Lippmann, Christoph Lübbert, Gernot Marx, Rafael Mikolajczyk, Anne Mlocek, Stefan Moritz, Christoph Müller, Susanne Müller, Ariadna Pérez Garriga, Lo An Phan-Vogtmann, Diana Pietzner, Mathias W. Pletz, Mario Popp, Maike Rebenstorff, Jonas Renz, Florian Rißner, Rainer Röhrig, Kutaiba Saleh, Sebastian G. Schönherr, Cord Spreckelsen, Anja Stempel, Abel Stolz, Eric Thomas, Susanne Thon, Daniel Tiller, Sebastian Uschmann, Sebastian Wendt, Thomas Wendt, Philipp Winnekens, Oliver Witzke, Stefan Hagel, André Scherag
{"title":"Leveraging electronic medical records to evaluate a computerized decision support system for staphylococcus bacteremia","authors":"Julia Palm, Ssuhir Alaid, Danny Ammon, Julian Brandes, Andreas Dürschmid, Claudia Fischer, Jonas Fortmann, Kristin Friebel, Sarah Geihs, Anne-Kathrin Hartig, Donghui He, Andrew J. Heidel, Petra Hetfeld, Roland Ihle, Suzanne Kahle, Verena Koi, Margarethe Konik, Frauke Kretzschmann, Henner Kruse, Norman Lippmann, Christoph Lübbert, Gernot Marx, Rafael Mikolajczyk, Anne Mlocek, Stefan Moritz, Christoph Müller, Susanne Müller, Ariadna Pérez Garriga, Lo An Phan-Vogtmann, Diana Pietzner, Mathias W. Pletz, Mario Popp, Maike Rebenstorff, Jonas Renz, Florian Rißner, Rainer Röhrig, Kutaiba Saleh, Sebastian G. Schönherr, Cord Spreckelsen, Anja Stempel, Abel Stolz, Eric Thomas, Susanne Thon, Daniel Tiller, Sebastian Uschmann, Sebastian Wendt, Thomas Wendt, Philipp Winnekens, Oliver Witzke, Stefan Hagel, André Scherag","doi":"10.1038/s41746-025-01569-3","DOIUrl":null,"url":null,"abstract":"<p>Infectious disease specialists (IDS) improve outcomes of patients with Staphylococcus bacteremia, but immediate IDS access is not always guaranteed. We investigated whether a care-integrated computerized decision support system (CDSS) can safely enhance the standard of care (SOC) for these patients. We conducted a multicenter, noninferiority, interventional stepped-wedge cluster randomized controlled trial relying on the data integration centers at five university hospitals. By this means, electronic medical records can be used for part of the trial documentation. We analyzed 5056 patients from 134 wards (<i>Staphylococcus</i> <i>aureus</i> (SAB): <i>n</i> = 812, coagulase-negative staphylococci (CoNS): <i>n</i> = 4244) and found that the CDSS was noninferior to the SOC for hospital mortality in all patients. Noninferiority regarding the 90-day mortality/relapse in SAB patients was not observed and there was no evidence for differences in vancomycin usage among CoNS patients. Despite low reported usage, physicians rated the CDSS’s usability favorably. <b>Trial registration</b>: drks.de; Identifier: DRKS00014320; Registration Date: 2019-05-06.</p>","PeriodicalId":19349,"journal":{"name":"NPJ Digital Medicine","volume":"29 1","pages":""},"PeriodicalIF":12.4000,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"NPJ Digital Medicine","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1038/s41746-025-01569-3","RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"HEALTH CARE SCIENCES & SERVICES","Score":null,"Total":0}
引用次数: 0
Abstract
Infectious disease specialists (IDS) improve outcomes of patients with Staphylococcus bacteremia, but immediate IDS access is not always guaranteed. We investigated whether a care-integrated computerized decision support system (CDSS) can safely enhance the standard of care (SOC) for these patients. We conducted a multicenter, noninferiority, interventional stepped-wedge cluster randomized controlled trial relying on the data integration centers at five university hospitals. By this means, electronic medical records can be used for part of the trial documentation. We analyzed 5056 patients from 134 wards (Staphylococcusaureus (SAB): n = 812, coagulase-negative staphylococci (CoNS): n = 4244) and found that the CDSS was noninferior to the SOC for hospital mortality in all patients. Noninferiority regarding the 90-day mortality/relapse in SAB patients was not observed and there was no evidence for differences in vancomycin usage among CoNS patients. Despite low reported usage, physicians rated the CDSS’s usability favorably. Trial registration: drks.de; Identifier: DRKS00014320; Registration Date: 2019-05-06.
传染病专家（IDS）改善了葡萄球菌菌血症患者的预后，但并不总是保证立即获得IDS。我们调查了一个护理集成的计算机决策支持系统（CDSS）是否可以安全地提高这些患者的护理标准（SOC）。我们在五所大学医院的数据整合中心开展了一项多中心、非劣效性、介入性楔步聚类随机对照试验。通过这种方式，电子病历可用于部分审判文件。我们分析了来自134个病房的5056例患者（金黄色葡萄球菌（SAB）： n = 812，凝固酶阴性葡萄球菌（con）： n = 4244），发现CDSS在所有患者的医院死亡率中都不低于SOC。没有观察到SAB患者90天死亡率/复发率的非劣效性，也没有证据表明在con患者中万古霉素的使用存在差异。尽管报告的使用率较低，但医生对CDSS的可用性评价较高。试验注册：drks.de；标识符:DRKS00014320;报名日期：2019-05-06。
期刊介绍：
npj Digital Medicine is an online open-access journal that focuses on publishing peer-reviewed research in the field of digital medicine. The journal covers various aspects of digital medicine, including the application and implementation of digital and mobile technologies in clinical settings, virtual healthcare, and the use of artificial intelligence and informatics.
The primary goal of the journal is to support innovation and the advancement of healthcare through the integration of new digital and mobile technologies. When determining if a manuscript is suitable for publication, the journal considers four important criteria: novelty, clinical relevance, scientific rigor, and digital innovation.
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