• Der Internist · May 2020

    Review

    [Improved patient safety through a clinical decision support system in laboratory medicine].

    • F Eckelt, J Remmler, T Kister, M Wernsdorfer, H Richter, M Federbusch, M Adler, A Kehrer, M Voigt, C Cundius, J Telle, J Thiery, and T Kaiser.
    • Institut für Laboratoriumsmedizin, Klinische Chemie und Molekulare Diagnostik, Universitätsmedizin Leipzig, Paul-List-Str. 13-15, 04103, Leipzig, Deutschland.
    • Internist (Berl). 2020 May 1; 61 (5): 452-459.

    BackgroundLaboratory diagnostics are essential for diagnosis, initiation of therapy, and monitoring of patients. Laboratory results that are overlooked or incorrectly interpreted lead to adverse events and endanger patient safety. Clinical decision support systems (CDSSs) may facilitate appropriate interpretation of results and subsequent medical response.ObjectivesThe research project on digital laboratory medicine (AMPEL) aims at developing a CDSS based on laboratory diagnostics, which supports practitioners in ensuring the necessary medical consequences.Materials And MethodsA literature review of CDSSs describes the current state of research. The research project AMPEL is presented with its objectives, challenges, and first results. Furthermore, the development of a framework and reporting system is illustrated through the clinical example of severe hypokalemia.Results And ConclusionThrough interdisciplinary development and constant optimization, a specific CDSS with high acceptance among clinicians was developed. Initial results in the case of severe hypokalemia show a positive effect on patient care. Thereby, more complex frameworks such as sepsis diagnostics or acute coronary syndrome are implemented. The limited availability of standardized and digital clinical data is challenging. In addition to the application of classic decision trees in CDSS, the use of machine learning offers a promising perspective for future developments.

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