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Computer decision support for acute kidney injury

current and future

Kashani, Kianoush

Current Opinion in Critical Care: December 2016 - Volume 22 - Issue 6 - p 520–526
doi: 10.1097/MCC.0000000000000353
RENAL SYSTEM: Edited by John Kellum

Purpose of review Growing awareness regarding the impact of acute kidney injury (AKI) as a grave consequence of critical illnesses resulted in the expansion of the need for early detection and appropriate management strategies. Clinical decision support systems (CDSS) can generate information to improve the care of AKI patients by providing point-of-care accurate patient-specific information and recommendations. Our objective is to describe the characteristics of CDSS and review the current knowledge regarding the impact of CDSS on patients in the acute care settings, and specifically for AKI.

Recent findings Several recent systematic analyses showed the positive impact of CDSS on critically ill patients care processes. These studies also highlighted the scarcity of data regarding the effect of CDSS on the patient outcomes. In the field of AKI, there have been several reports to describe development and validation of homegrown CDSS and electronic alert systems. A large number of investigations showed the implementation of CDSS could improve the quality of AKI care; although, only in a very small subgroup of these studies patient outcomes improved.

Summary The heterogeneity of these studies in their size, design, and conduct has produced controversial findings; hence, this has left the field completely open for further investigations.

aDivision of Nephrology and Hypertension

bDivision of Pulmonary and Critical Care Medicine, Department of Medicine, Mayo Clinic, Rochester, Minnesota, USA

Correspondence to Dr Kianoush Kashani, MD, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA. Tel: +1 507 266 7093; e-mail:

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