The effect of clinical decision support systems on clinical outcomes in acute kidney injury: a systematic review and meta-analysis of randomized controlled trials
Obieda Altobaishat,
Mohamed Abouzid,
Ahmed Mazen Amin,
Abdallah Bani-Salameh,
Mohammad Tanashat,
Omar Abdullah Bataineh,
Mustafa Turkmani,
Mohamed Abuelazm,
Muner M. B. Mohamed
Affiliations
Obieda Altobaishat
Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan
Mohamed Abouzid
Department of Physical Pharmacy and Pharmacokinetics, Faculty of Pharmacy, Poznan University of Medical Sciences, Poznan, Poland
Ahmed Mazen Amin
Faculty of Medicine, Mansoura University, Mansoura, Egypt
Abdallah Bani-Salameh
Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan
Mohammad Tanashat
Faculty of Medicine, Yarmouk University, Irbid, Jordan
Omar Abdullah Bataineh
Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan
Mustafa Turkmani
Faculty of Medicine, Michigan State University, East Lansing, MI, USA
Mohamed Abuelazm
Faculty of Medicine, Tanta University, Tanta, Egypt
Muner M. B. Mohamed
Department of Nephrology, Ochsner Health System, New Orleans, LA, USA
Objectives To determine whether clinical decision support systems (CDSS) for acute kidney injury (AKI) would enhance patient outcomes in terms of mortality, dialysis, and acute kidney damage progression.Methods The systematic review and meta-analysis included the relevant randomized controlled trials (RCTs) retrieved from PubMed, EMBASE, Web of Science, Cochrane, and SCOPUS databases until 21st January 2024. The meta-analysis was done using (RevMan 5.4.1). PROSPERO ID: CRD42024517399.Results Our meta-analysis included ten RCTs with 18,355 patients. There was no significant difference between CDSS and usual care in all-cause mortality (RR: 1.00 with 95% CI [0.93, 1.07], p = 0.91) and renal replacement therapy (RR: 1.11 with 95% CI [0.99, 1.24], p = 0.07). However, CDSS was significantly associated with a decreased incidence of hyperkalemia (RR: 0.27 with 95% CI [0.10, 0.73], p = 0.01) and increased eGFR change (MD: 1.97 with 95% CI [0.47, 3.48], p = 0.01).Conclusions CDSS were not associated with clinical benefit in patients with AKI, with no effect on all-cause mortality or the need for renal replacement therapy. However, CDSS reduced the incidence of hyperkalemia and improved eGFR change in AKI patients.
