The Reliability of an Epilepsy Treatment Clinical Decision Support System

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Standridge S, Faist R, Pestian J, Glauser T, Ittenbach R. The Reliability of an Epilepsy Treatment Clinical Decision Support System. J Med Syst. 2014 Oct;38(10):119. [1]


Introduction

It is seen that the treatment of epilepsy is a difficult endeavor for physicians because of the heterogeneous nature of the disease, lack of evidence based treatment protocols and physicians’ inadequate knowledge of the latest protocols and technologies. Thus, a Clinical Decision Support system is found to be very useful in supporting physicians and reducing ADEs and improving healthcare delivery. The authors have developed such a knowledge based CDS system for epilepsy treatment and are now testing the reliability of the ET- CDS(a component of the CDS) , as a part of validation testing.

Development

The CDS system framework being tested is named “ Children’s Hospital Resource In Selecting Therapy Individualized Expert” (CHRISTINE). CHRISTINE provides an environment for developing and implementing different expert systems such as the multi-expert epilepsy treatment CDS (ET-CDS) system, which in turn comprises of two applications: an expert opinion collection system and a patient data system. On entering the patient details, the output provided is a selection of recommended treatment options based on the disease description, clinical evidence and drug drug interaction records.

Methods

Consistency of the recommendations of epilepsy treatment clinical decision support system for five pediatric epilepsy syndrome profiles was tested in three areas including the preferred anti epilepsy drug choice, the top three recommended choices, and the rank order of the three choices.

Results

The CDS system demonstrated a 100 % reliability on 15,000 executions carried out on five common pediatric epilepsy syndromes ( 100% match rates on treatment reports and system generated reports well as a match to the order of recommended treatment interventions).

Conclusion

The ET-CDS system is a reliable CTS in the treatment of pediatric epilepsy.

Discussion

Reliability testing is the first step in determining the efficiency of CDS systems. The authors aim to carry out further, rigorous validity testing for the same. Also the current study had limitations like restricting treatment options to only three.

Comments

I would be interested in knowing how effective the system was in reducing ADEs.

References

  1. Standridge S, Faist R, Pestian J, Glauser T, Ittenbach R. The Reliability of an Epilepsy Treatment Clinical Decision Support System. J Med Syst. 2014 Oct;38(10):119. http://link.springer.com/article/10.1007%2Fs10916-014-0119-9#