Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 31103
Clinical Benefits of an Embedded Decision Support System in Anticoagulant Control

Authors: Tony Austin, Shanghua Sun, Nathan Lea, Steve Iliffe, Dipak Kalra, David Ingram, David Patterson


Computer-based decision support (CDSS) systems can deliver real patient care and increase chances of long-term survival in areas of chronic disease management prone to poor control. One such CDSS, for the management of warfarin, is described in this paper and the outcomes shown. Data is derived from the running system and show a performance consistently around 20% better than the applicable guidelines.

Keywords: Decision Support, Anticoagulant Control

Digital Object Identifier (DOI):

Procedia APA BibTeX Chicago EndNote Harvard JSON MLA RIS XML ISO 690 PDF Downloads 1657


[1] J.R. Mohr, "A Quantitative Perspective on the Virtual Patient Record (VPR) and its realization." Medinfo 9(1): 21-25. 1998.
[2] K. Kawamoto, C.A. Houlihan, E.A. Balas, and D.F. Lobach. "Improving clinical practice using clinical decision support systems: a systematic review of trials to identify features critical to success". BMJ April 2005; 330: 765
[3] S. Turner, S. Iliffe, M. Downs, M. Bryans, J. Wilcock and T. Austin, "Decision support software for dementia diagnosis and management in primary care: relevance and potential". 2001 Annual Conference of the European Health Management Association, Granada, Spain, June 2001
[4] B.D. Vadher, D.L.H. Patterson and M. Leaning, "Comparison of Oral Anticoagulant Control by a Nurse-Practitioner Using a Computer Decision-Support System With That by Clinicians." Clinical Laboratory Haematology 19:203-207.
[5] B. Vadher, D.L.H. Patterson and M. Leaning, "Evaluation of a decision support system for initiation and control of oral anticoagulation in a randomised trial" BMJ 1997;314:1252
[6] B.D. Vadher, D.L.H. Patterson and M.S. Leaning, "Validation of an algorithm for oral anticoagulant dosing and appointment scheduling." Clinical Laboratory Haematology 17:339-345. 1995.
[7] B.D. Vadher, "Development and Evaluation of a decision-aid for warfarin dosing and monitoring during initiation and maintenance therapy." M.D. Thesis. 1998
[8] H.L. Chin and P. Wallace, "Embedding guidelines into direct physician order entry: Simple methods, powerful results." Proceedings of the American Medical Informatics Association Annual Symposium: 221-5. 1999.
[9] D.W. Bates, J.M. Teich, J. Lee, D. Seger, G.J. Kuperman, N. Ma'Luf, D. Boyle and L. Leape, "The impact of computerized physician order entry on medication error prevention." Journal of the American Medical Informatics Association 6(4): 313-21. 1999.
[10] G.J. Kuperman, J.M. Teich, M.J. Tanasijevic, N. Ma'Luf, E. Rittenberg, A Jha, J. Fiskio, J. Winkelman and D.W. Bates, "Improving response to critical laboratory results with automation: Results of a randomized controlled trial." Journal of the American Medical Informatics Association 6(6): 512-22. 1999
[11] D.M. Rind, R. Davis and C. Safran, "Designing studies of computerbased alerts and reminders." MD Computing 12(2): 122-6. 1995.
[12] G. Chatellier, I. Colombet and P. Degoulet, "Computer-adjusted dosage of anticoagulant therapy improves the quality of anticoagulation." Medinfo 9(2): 819-823. 1998.
[13] G. Chatellier, I. Colombet and P. Degoulet, "An overview of the effect of computer assisted management of anticoagulant therapy on the quality of anticoagulation." International Journal of Medical Informatics 49(3): 311-20. 1998.
[14] D. Kalra, D.L.H. Patterson, T. Austin, D. Ingram, D. Lloyd, J. Milan, J. Grimson and W Grimson, "Synapses In Use: Supporting Cardiac Care at the Whittington Hospital." Proceedings of Toward An Electronic Health Record Europe '98. 306-312. 1998.
[15] T. Austin, S. Iliffe, M.S. Leaning and M. Modell, "A Prototype Computer Decision Support System for the Management of Asthma." Journal of Medical Systems 20(1):45-55. 1996.
[16] G. Lanzola. and M. Stefanelli, "A specialised framework for medical diagnostic knowledge-based systems." Computers and Biomedical Research 25:351-365. 1992.
[17] C.P. Friedman and J.C. Wyatt, "Evaluation Methods in Medical Informatics." Springer. ISBN: 0-387-94228-9. 2000.
[18] T. Austin, "The Development and Comparative Evaluation of Middleware and Database Architectures for the Implementation of an Electronic Healthcare Record." PhD Thesis. 2004.
[19] British Committee for Standards In Haematology. Guidelines on oral anticoagulation: Third Edition. British Journal of Haematology.1998;101:374-387.
[20] A. Davies, M.J. Buxton, D.L.H. Patterson and J. Webster-King, "Anticoagulant Monitoring Service Delivery: A Comparison of Costs of Hospital and Community Outreach Clinics." Clinical Laboratory Haematology 22:33-40. 2000.