Measures of success of computerized clinical decision support systems: An overview of systematic reviews

Introduction: Although increasing number of clinical decision support systems (CDSSs) were introduced, a lack of rigorous evaluations of information systems (IS) success limits these systems' usage and diffusion. The purpose of this overview is to identify specific features which are critical to information system success based on the updated DeLone & McLean IS Success Model from published systematic reviews (SRs) over the last 10 years. Methods: This systematic review was prepared in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Results: There were 39 measures were synthesized from 45 SRs published during 2009-2020 and were classified into 16 categories and 6 dimensions. The most frequently displayed dimension was net benefit, which was divided into four categories: process of care, professional competency, patient outcomes and cost-effectiveness. Very limited publications summarized evaluation metrics under the remaining five dimensions, excepted validity in system performance category and acceptance in use behavior category. Conclusion: The findings of this overview may have meaningful and useful implications to the evaluation of CDSSs. Future research needs to focus on developing a comprehensive evaluation framework through summarizing evaluation metrics on the base of theoretical model, which is critical to CDSSs development, utilization and research. Furthermore, multi-centered, large sample size and long-term follow up studies are required to ensure more reliable evidence on patient outcomes of CDSSs usage. (c) 2020 Fellowship of Postgraduate Medicine. Published by Elsevier Ltd. All rights reserved.

Automated summary

This study identified critical features for the success of information systems (IS) based on the DeLone & McLean IS Success Model. Results showed that success was closely related to net benefit, process of care, professional competency, patient outcomes, and cost-effectiveness. Future research needs to focus on developing a comprehensive evaluation framework based on theoretical models, and conduct multi-centered, large sample size, and long-term follow-up studies for more reliable evidence.