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Clinical decision support system for the management of osteoporosis compared to NOGG guidelines and an osteology specialist: a validation pilot study

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dc.contributor Háskóli Íslands
dc.contributor University of Iceland
dc.contributor Háskólinn í Reykjavík
dc.contributor Reykjavik University
dc.contributor.author Guðmundsson, Haukur Týr
dc.contributor.author Hansen, Karen E.
dc.contributor.author Halldórsson, Bjarni
dc.contributor.author Ludviksson, Bjorn
dc.contributor.author Gudbjornsson, Bjorn
dc.date.accessioned 2020-05-18T13:34:56Z
dc.date.available 2020-05-18T13:34:56Z
dc.date.issued 2019-02-01
dc.identifier.citation Gudmundsson, H.T., Hansen, K.E., Halldorsson, B.V. et al. Clinical decision support system for the management of osteoporosis compared to NOGG guidelines and an osteology specialist: a validation pilot study. BMC Medical Informatics and Decision Making 19, 27 (2019). https://doi.org/10.1186/s12911-019-0749-4
dc.identifier.issn 1472-6947
dc.identifier.uri https://hdl.handle.net/20.500.11815/1813
dc.description Publisher's version (útgefin grein)
dc.description.abstract Background: Although osteoporosis is an easily diagnosed and treatable condition, many individuals remain untreated. Clinical decision support systems might increase appropriate treatment of osteoporosis. We designed the Osteoporosis Advisor (OPAD), a computerized tool to support physicians managing osteoporosis at the point-of-care. The present study compares the treatment recommendations provided by OPAD, an expert physician and the National Osteoporosis Guideline Group (NOGG). Methods: We performed a retrospective analysis of 259 patients attending the outpatient osteoporosis clinic at the University Hospital in Iceland. We entered each patient's data into the OPAD and recorded the OPAD diagnostic comments, 10-year risk of major osteoporotic fracture and treatment options. We compared OPAD recommendations to those given by the osteoporosis specialist, and to those of the NOGG. Results: Risk estimates made by OPAD were highly correlated with those from FRAX (r = 0.99, 95% CI 0.99, 1.00 without femoral neck BMD; r = 0.98, 95% CI, 0.97, 0.99 with femoral neck BMD. Reassurance was recommended by the expert, NOGG and the OPAD in 68, 63 and 52% of cases, respectively. Likewise, intervention was recommended by the expert, NOGG, and the OPAD in 32, 37 and 48% of cases, respectively. The OPAD demonstrated moderate agreement with the physician (kappa 0.51, 95% CI 0.41, 0.61) and even higher agreement with NOGG (kappa 0.69, 95% CI 0.60, 0.77). Conclusion: Primary care physicians can use the OPAD to assess and treat patients' skeletal health. Recommendations given by OPAD are consistent with expert opinion and existing guidelines.
dc.description.sponsorship This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.
dc.format.extent 27
dc.language.iso en
dc.publisher Springer Science and Business Media LLC
dc.relation.ispartofseries BMC Medical Informatics and Decision Making;19(1)
dc.rights info:eu-repo/semantics/openAccess
dc.subject Clinical decision support system (CDSS)
dc.subject Clinical guidelines
dc.subject Fracture risk
dc.subject Osteoporosis
dc.subject Treatment recommendations
dc.subject Beinþynning
dc.subject Upplýsingakerfi
dc.subject Sjúkdómsgreining
dc.subject Áhættuþættir
dc.title Clinical decision support system for the management of osteoporosis compared to NOGG guidelines and an osteology specialist: a validation pilot study
dc.type info:eu-repo/semantics/article
dcterms.license Open Access. This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
dc.description.version Peer Reviewed
dc.identifier.journal BMC Medical Informatics and Decision Making
dc.identifier.doi 10.1186/s12911-019-0749-4
dc.relation.url https://bmcmedinformdecismak.biomedcentral.com/articles/10.1186/s12911-019-0749-4
dc.contributor.department Læknadeild (HÍ)
dc.contributor.department Faculty of Medicine (UI)
dc.contributor.school Heilbrigðisvísindasvið (HÍ)
dc.contributor.school School of Health Sciences (UI)
dc.contributor.school School of Science and Engineering (RU)
dc.contributor.school Tækni- og verkfræðideild (HR)

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