Challenges and insights from implementing clinical decision support systems for radiologic imaging: experience from the MIDAS trial.

IF 4.1 2区医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

Insights into Imaging Pub Date : 2025-07-05 DOI:10.1186/s13244-025-02027-0

Thomas Kroencke, Stijntje W Dijk, Moritz C Halfmann, Claudia Wollny, Joerg Barkhausen, Olav Janssen, Dimitris Rizopoulos, M G Myriam Hunink

{"title":"Challenges and insights from implementing clinical decision support systems for radiologic imaging: experience from the MIDAS trial.","authors":"Thomas Kroencke, Stijntje W Dijk, Moritz C Halfmann, Claudia Wollny, Joerg Barkhausen, Olav Janssen, Dimitris Rizopoulos, M G Myriam Hunink","doi":"10.1186/s13244-025-02027-0","DOIUrl":null,"url":null,"abstract":"Clinical decision support systems (CDSSs) have been developed to give guidance for referring physicians to make appropriate decisions at the point of care. The MIDAS study, a multicenter cluster randomized trial at four German university hospitals, was designed to evaluate the effectiveness of a CDSS for imaging referral (ESR iGuide) in routine clinical care. Based on our experience within the MIDAS study, we aim to describe the hurdles and difficulties, as well as the various insights gained, in the process of implementing a CDSS in a clinical and research setting. To successfully implement a CDSS for imaging requests, it is essential to monitor and address technical issues, adapt local workflows, define the scope and content, and prioritize user experience and acceptance.Critical relevance statement: By identifying and addressing the various technical, content-related, and workflow challenges, this article gives valuable insights to facilitate future implementations of the ESR iGuide and similar clinical decision support systems CDSSs for imaging orders.Trial registration number: Approval from the Medical Ethics Review Committee was obtained under protocol numbers 20-069 (Augsburg), B 238/21 (Kiel), 20-318 (Lübeck) and 2020-15125 (Mainz). The trial is registered in the ClinicalTrials.gov register under registration number NCT05490290.Key points: This manuscript reviews the challenges of implementing a clinical decision support system (CDSS) (ESR iGuide). Clinical implementation of a CDSS for imaging requests requires monitoring and adjustments in technical issues, local workflow, scope and content, and attention to user experience and acceptance. Our experience may equip stakeholders with the knowledge to proactively address these challenges.","PeriodicalId":13639,"journal":{"name":"Insights into Imaging","volume":"16 1","pages":"152"},"PeriodicalIF":4.1000,"publicationDate":"2025-07-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12228898/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Insights into Imaging","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1186/s13244-025-02027-0","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING","Score":null,"Total":0}

引用次数: 0

Abstract

Clinical decision support systems (CDSSs) have been developed to give guidance for referring physicians to make appropriate decisions at the point of care. The MIDAS study, a multicenter cluster randomized trial at four German university hospitals, was designed to evaluate the effectiveness of a CDSS for imaging referral (ESR iGuide) in routine clinical care. Based on our experience within the MIDAS study, we aim to describe the hurdles and difficulties, as well as the various insights gained, in the process of implementing a CDSS in a clinical and research setting. To successfully implement a CDSS for imaging requests, it is essential to monitor and address technical issues, adapt local workflows, define the scope and content, and prioritize user experience and acceptance.

Critical relevance statement: By identifying and addressing the various technical, content-related, and workflow challenges, this article gives valuable insights to facilitate future implementations of the ESR iGuide and similar clinical decision support systems CDSSs for imaging orders.

Trial registration number: Approval from the Medical Ethics Review Committee was obtained under protocol numbers 20-069 (Augsburg), B 238/21 (Kiel), 20-318 (Lübeck) and 2020-15125 (Mainz). The trial is registered in the ClinicalTrials.gov register under registration number NCT05490290.

Key points: This manuscript reviews the challenges of implementing a clinical decision support system (CDSS) (ESR iGuide). Clinical implementation of a CDSS for imaging requests requires monitoring and adjustments in technical issues, local workflow, scope and content, and attention to user experience and acceptance. Our experience may equip stakeholders with the knowledge to proactively address these challenges.

查看原文本刊更多论文

来自实施临床决策支持系统的挑战和见解：来自MIDAS试验的经验。

临床决策支持系统（cdss）已被开发用于指导转诊医生在护理点做出适当的决定。MIDAS研究是一项在四所德国大学医院进行的多中心集群随机试验，旨在评估CDSS在常规临床护理中用于影像学转诊（ESR指南）的有效性。根据我们在MIDAS研究中的经验，我们的目标是描述在临床和研究环境中实施CDSS过程中的障碍和困难，以及所获得的各种见解。为了成功地实现成像请求的CDSS，必须监视和处理技术问题，适应本地工作流，定义范围和内容，并优先考虑用户体验和接受度。关键相关性声明：通过识别和解决各种技术、内容相关和工作流程挑战，本文提供了有价值的见解，以促进ESR指南和类似的临床决策支持系统cdss在成像订单中的未来实现。试验注册号：获得医学伦理审查委员会批准，方案号为20-069（奥格斯堡）、B 238/21（基尔）、20-318（莱尔贝克）和2020-15125（美因茨）。该试验已在ClinicalTrials.gov注册，注册号为NCT05490290。重点：本文回顾了实施临床决策支持系统（CDSS）的挑战（ESR指南）。临床实施影像请求的CDSS需要对技术问题、本地工作流程、范围和内容进行监控和调整，并注意用户体验和接受度。我们的经验可以为利益相关者提供知识，以积极应对这些挑战。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Insights into Imaging Medicine-Radiology, Nuclear Medicine and Imaging

CiteScore

7.30

自引率

4.30%

发文量

182

审稿时长

13 weeks

期刊介绍： Insights into Imaging (I³) is a peer-reviewed open access journal published under the brand SpringerOpen. All content published in the journal is freely available online to anyone, anywhere! I³ continuously updates scientific knowledge and progress in best-practice standards in radiology through the publication of original articles and state-of-the-art reviews and opinions, along with recommendations and statements from the leading radiological societies in Europe. Founded by the European Society of Radiology (ESR), I³ creates a platform for educational material, guidelines and recommendations, and a forum for topics of controversy. A balanced combination of review articles, original papers, short communications from European radiological congresses and information on society matters makes I³ an indispensable source for current information in this field. I³ is owned by the ESR, however authors retain copyright to their article according to the Creative Commons Attribution License (see Copyright and License Agreement). All articles can be read, redistributed and reused for free, as long as the author of the original work is cited properly. The open access fees (article-processing charges) for this journal are kindly sponsored by ESR for all Members. The journal went open access in 2012, which means that all articles published since then are freely available online.