PT - JOURNAL ARTICLE AU - Sunjaya, Anthony Paulo AU - Ansari, Sameera AU - Jenkins, Christine TI - Systematic review of clinical decision support systems for breathlessness in outpatient settings AID - 10.1183/13993003.congress-2021.PA3634 DP - 2021 Sep 05 TA - European Respiratory Journal PG - PA3634 VI - 58 IP - suppl 65 4099 - https://publications.ersnet.org//content/58/suppl_65/PA3634.short 4100 - https://publications.ersnet.org//content/58/suppl_65/PA3634.full SO - Eur Respir J2021 Sep 05; 58 AB - Introduction: Breathlessness is a complex, highly prevalent symptom. Less than 30% of initial diagnoses for breathlessness are reported to be concordant with the final diagnosis. Clinical decision support systems (CDSS) have been known to aid diagnosis and management. This systematic review aimed to evaluate the impact of CDSS for breathlessness and associated conditions in real-world outpatient settings.Methods: Studies published between 1st January 2000 to 25th August 2020 were obtained from 14 databases including CENTRAL, Embase and PubMed. Main outcomes were patients’ health outcomes, provider use and adherence, time and test efficiency, and diagnostic concordance. Other outcomes included user satisfaction and economic evaluation.Results: A total of 3808 records were screened; 33 studies were included of which 27 were RCTs and most (58%) were in adults. Seventeen studies were in primary care, 11 in hospital outpatient/emergency departments (ED) and rest in mixed settings. Five CDSS focused on assessment, one on assessment and management, the rest on management. Most were for asthma (17), COPD (2), asthma and COPD (3), and other chronic conditions (10). One CDSS explicitly addressed breathlessness for assessing pulmonary embolism in the ED and found significantly lower chest radiation exposure and medical costs. Low uptake was a main barrier to effectiveness of CDSS.Conclusions: While CDSS for breathlessness-associated diseases were found, there was none specific to breathlessness as a symptom. CDSS were mostly siloed to one or two diseases, few provided support for assessment, or combined assessment and management which may improve workflow integration and increase uptake.FootnotesCite this article as: European Respiratory Journal 2021; 58: Suppl. 65, PA3634.This abstract was presented at the 2021 ERS International Congress, in session “Prediction of exacerbations in patients with COPD”.This is an ERS International Congress abstract. No full-text version is available. Further material to accompany this abstract may be available at www.ers-education.org (ERS member access only).