Prospective Evaluation of Medication-Related Clinical Decision Support Over-Rides in the ICU

  • February 9, 2018

Recent data suggested that clinical decision support (CDS) alerts displayed in health records were frequently being over-ridden by clinicians, and often inappropriately. This CRICO-funded study aimed to evaluate potential harm associated with medication-related CDS over-rides in the intensive care unit (ICU).

Study Conclusion

The study’s findings included, “Approximately four of five identified clinical decision over-rides were appropriately over-ridden, with the rate varying by alert type. However, inappropriate over-rides were six times as likely to be associated with potential and definite adverse drug events, compared with appropriate over-rides.

Also, the researchers recommended that “further efforts should be targeted at improving the positive predictive value of clinical decision support such as by suppressing alerts that are appropriately over-ridden.”


Citation for the Full-text Article

Wong A, Amato MG, Seger DL, Rehr C, Wright A, Slight SP, Beeler PE, Orav EJ, Bates DW. Prospective evaluation of medication-related clinical decision support over-rides in the intensive care unit.  BMJ Quality and Safety . Epub ahead of print: [February 9, 2018]. doi:10.1136/bmjqs-2017-007531.