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Clinical decision support system RHINA in the diagnosis and treatment of acute or chronic rhinosinusitis

. 2021 Aug 09 ; 21 (1) : 239. [epub] 20210809

Language English Country Great Britain, England Media electronic

Document type Journal Article

Links

PubMed 34372852
PubMed Central PMC8350307
DOI 10.1186/s12911-021-01599-3
PII: 10.1186/s12911-021-01599-3
Knihovny.cz E-resources

BACKGROUND: Rhinosinusitis is an inflammation of the sinonasal cavity which affects roughly one in seven people per year. Acute rhinosinusitis (ARS) is mostly, apart from allergic etiology, caused by a viral infection and, in some cases (30-50%), by a bacterial superinfection. Antibiotics, indicated only in rare cases according to EPOS guidelines, are nevertheless prescribed in more than 80% of ARS cases, which increases the resistant bacterial strains in the population. METHODS: We have designed a clinical decision support system (CDSS), RHINA, based on a web application created in HTML 5, using JavaScript, jQuery, CCS3 and PHP scripting language. The presented CDSS RHINA helps general physicians to decide whether or not to prescribe antibiotics in patients with rhinosinusitis. RESULTS: In a retrospective study of a total of 1465 patients with rhinosinusitis, the CDSS RHINA presented a 90.2% consistency with the diagnosis and treatment made by the ENT specialist. CONCLUSION: Patients assessed with the assistance of our CDSS RHINA would decrease the over-prescription of antibiotics, which in turn would help to reduce the bacterial resistance to the most commonly prescribed antibiotics.

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Fokkens WJ, et al. EPOS 2012: European position paper on rhinosinusitis and nasal polyps 2012. A summary for otorhinolaryngologists. Rhinology. 2012;50(1):1–12. doi: 10.4193/Rhino50E2. PubMed DOI

Meltzer EO, Hamilos DL. Rhinosinusitis diagnosis and management for the clinician: a synopsis of recent consensus guidelines. Mayo Clin Proc. 2011;86(5):427–443. doi: 10.4065/mcp.2010.0392. PubMed DOI PMC

Wang DY, et al. A survey on the management of acute rhinosinusitis among Asian physicians. Rhinology. 2011;49(3):264–271. doi: 10.4193/Rhino10.169. PubMed DOI

Berg O, Carenfelt C, Rystedt G, Anggard A. Occurrence of asymptomatic sinusitis in common cold and other acute ENT-infections. Rhinology. 1986;24(3):223–225. PubMed

Smith SS, Ference EH, Evans CT, Tan BK, Kern RC, Chandra RK. The prevalence of bacterial infection in acute rhinosinusitis: a systematic review and meta-analysis. Laryngoscope. 2015;125(1):57–69. doi: 10.1002/lary.24709. PubMed DOI PMC

Payne SC, Benninger MS. Staphylococcus aureus is a major pathogen in acute bacterial rhinosinusitis: a meta-analysis. Clin Infect Dis. 2007;45(10):e121–e127. doi: 10.1086/522763. PubMed DOI

Smith SS, Kern RC, Chandra RK, Tan BK, Evans CT. Variations in antibiotic prescribing of acute rhinosinusitis in United States ambulatory settings. Otolaryngol Head Neck Surg. 2013;148(5):852–859. doi: 10.1177/0194599813479768. PubMed DOI PMC

Jorgensen LC, Friis-Christensen S, Cordoba-Currea G, Llor C, Bjerrum L. Antibiotic prescribing in patients with acute rhinosinusitis is not in agreement with European recommendations. Scand J Prim Health Care. 2013;31(2):101–105. doi: 10.3109/02813432.2013.788270. PubMed DOI PMC

Young J, et al. Antibiotics for adults with clinically diagnosed acute rhinosinusitis: a meta-analysis of individual patient data. Lancet. 2008;371(9616):908–914. doi: 10.1016/S0140-6736(08)60416-X. PubMed DOI

Hickner JM, et al. Principles of appropriate antibiotic use for acute rhinosinusitis in adults: background. Ann Intern Med. 2001;134(6):498–505. doi: 10.7326/0003-4819-134-6-200103200-00017. PubMed DOI

Buchen V. Primarycare-based randomi sed placebo controlled trial of antibiotic treatment in acute maxillary sinusitis. Lancet. 1997;349(9053):683–687. doi: 10.1016/S0140-6736(96)07585-X. PubMed DOI

Anon JB, et al. Antimicrobial treatment guidelines for acute bacterial rhinosinusitis. Otolaryngol Head Neck Surg. 2004;130(1 Suppl):1–45. doi: 10.1016/j.otohns.2003.12.003. PubMed DOI PMC

Head K, et al. Systemic and topical antibiotics for chronic rhinosinusitis. Cochrane Database Syst Rev. 2016;4:CD011994. doi: 10.1002/14651858.CD011994.pub2. PubMed DOI PMC

Brozek JL, et al. Grading quality of evidence and strength of recommendations in clinical practice guidelines. Part 1 of 3. An overview of the GRADE approach and grading quality of evidence about interventions. Allergy. 2009;64(5):669–677. doi: 10.1111/j.1398-9995.2009.01973.x. PubMed DOI

Punekar YS, Ahmad A, Saleh HA. Estimating the effect of nasal steroid treatment on repeat polypectomies: survival time analysis using the General Practice Research Database. Rhinology. 2011;49(2):190–194. doi: 10.4193/Rhino10.004. PubMed DOI

Bronzwaer SL, et al. A European study on the relationship between antimicrobial use and antimicrobial resistance. Emerg Infect Dis. 2002;8(3):278–282. doi: 10.3201/eid0803.010192. PubMed DOI PMC

Magee JT, Pritchard EL, Fitzgerald KA, Dunstan FD, Howard AJ. Antibiotic prescribing and antibiotic resistance in community practice: retrospective study, 1996–8. BMJ. 1999;319(7219):1239–1240. doi: 10.1136/bmj.319.7219.1239. PubMed DOI PMC

van de Sande-Bruinsma N, et al. Antimicrobial drug use and resistance in Europe. Emerg Infect Dis. 2008;14(11):1722–1730. doi: 10.3201/eid1411.070467. PubMed DOI PMC

Goff DA, et al. A global call from five countries to collaborate in antibiotic stewardship: united we succeed, divided we might fail. Lancet Infect Dis. 2017;17(2):e56–e63. doi: 10.1016/S1473-3099(16)30386-3. PubMed DOI

Mainz JG, Jaudszus A, Pletz MW. Development of a clinical decision rule for diagnosing sinus infections—to reduce unnecessary antibiotic prescribing. Expert Rev Clin Pharmacol. 2018;11(10):923–925. doi: 10.1080/17512433.2018.1524753. PubMed DOI

Baiardini I, Braido F, Bonini M, Compalati E, Canonica GW. Why do doctors and patients not follow guidelines? Curr Opin Allergy Clin Immunol. 2009;9(3):228–233. doi: 10.1097/ACI.0b013e32832b4651. PubMed DOI

Mickan S, Atherton H, Roberts NW, Heneghan C, Tilson JK. Use of handheld computers in clinical practice: a systematic review. BMC Med Inform Decis Mak. 2014;14:56. doi: 10.1186/1472-6947-14-56. PubMed DOI PMC

Buchanan BG, Shortliffe EH. Rule-based expert systems: The MYCIN experiments of the Stanford HEURISTIC Programming Project. Reading: Addison-Wesley; 1984.

Miller RA. INTERNIST-1/CADUCEUS: problems facing expert consultant programs. Methods Inf Med. 1984;23(01):9–14. doi: 10.1055/s-0038-1635320. PubMed DOI

Adams ID, et al. Computer aided diagnosis of acute abdominal pain: a multicentre study. Br Med J (Clin Res Ed) 1986;293(6550):800–804. doi: 10.1136/bmj.293.6550.800. PubMed DOI PMC

Aikins JS, Kunz JC, Shortliffe EH, Fallat RJ. PUFF: an expert system for interpretation of pulmonary function data. Comput Biomed Res. 1983;16(3):199–208. doi: 10.1016/0010-4809(83)90021-6. PubMed DOI

Shortliffe EH. Update on ONCOCIN: a chemotherapy advisor for clinical oncology. Med Inform (Lond) 1986;11(1):19–21. doi: 10.3109/14639238608994970. PubMed DOI

Pivnickova L, Dolinay V, Vasek V. Multilayer neural network in differential diagnosis of balance disorders. In: Proceedings of the 16th WSEAS International Conference on Systems, Kos Island, Greece, July 14–17, 2012. WSEAS Press, p. 356–361.

Bousquet J, et al. MACVIA clinical decision algorithm in adolescents and adults with allergic rhinitis. J Allergy Clin Immunol. 2016;138(2):367–374. doi: 10.1016/j.jaci.2016.03.025. PubMed DOI

Courbis AL, et al. Electronic Clinical Decision Support System for allergic rhinitis management: MASK e-CDSS. Clin Exp Allergy. 2018;48(12):1640–1653. doi: 10.1111/cea.13230. PubMed DOI

Berner ES. Clinical decision support systems. Berlin: Springer; 2016.

Kohn LT, Corrigan JM, Donaldson MS. To err is human: building a safer health system. In: Kohn LT, Corrigan JM, Donaldson MS, editors. To err is human: building a safer health system. Washington; 2000.

Institute of Medicine (US) Committee on Quality of Health Care in America. Crossing the quality chasm: a new health system for the 21st century. Washington (DC): National Academies Press (US); 2001. PMID: 25057539. PubMed

Bates DW, et al. Effect of computerized physician order entry and a team intervention on prevention of serious medication errors. JAMA. 1998;280(15):1311–1316. doi: 10.1001/jama.280.15.1311. PubMed DOI

Miller RA. Why the standard view is standard: people, not machines, understand patients' problems. J Med Philos. 1990;15(6):581–591. doi: 10.1093/jmp/15.6.581. PubMed DOI

Joseph SS, Tan KH. Health decision support systems (1). Aspen Publishers, Inc.; 1998; pp. 5–6.

Marakas GM. Decision support systems in the twenty-first century. Upper Saddle River, NJ: Prentice Hall; 1998.

Garg AX, et al. Effects of computerized clinical decision support systems on practitioner performance and patient outcomes: a systematic review. JAMA. 2005;293(10):1223–1238. doi: 10.1001/jama.293.10.1223. PubMed DOI

Holst H, et al. Automated interpretation of ventilation-perfusion lung scintigrams for the diagnosis of pulmonary embolism using artificial neural networks. Eur J Nucl Med. 2000;27(4):400–406. doi: 10.1007/s002590050522. PubMed DOI

Bradford NK. Interventions to increase the use of electronic health information by healthcare practitioners to improve clinical practice and patient outcomes. Int J Evid Based Healthc. 2016;14(3):136–137. doi: 10.1097/XEB.0000000000000074. PubMed DOI

Giarratana RG. Expert systems: principles and programming. Automatica. 1991;27(3):585–590.

Stacey D, et al. Decision aid for patients considering total knee arthroplasty with preference report for surgeons: a pilot randomized controlled trial. BMC Musculoskelet Disord. 2014;15:54. doi: 10.1186/1471-2474-15-54. PubMed DOI PMC

van Weert JC, van Munster BC, Sanders R, Spijker R, Hooft L, Jansen J. Decision aids to help older people make health decisions: a systematic review and meta-analysis. BMC Med Inform Decis Mak. 2016;16:45. doi: 10.1186/s12911-016-0281-8. PubMed DOI PMC

Sim I, et al. Clinical decision support systems for the practice of evidence-based medicine. J Am Med Inform Assoc. 2001;8(6):527–534. doi: 10.1136/jamia.2001.0080527. PubMed DOI PMC

Miller RA, Schaffner KF, Meisel A. Ethical and legal issues related to the use of computer programs in clinical medicine. Ann Intern Med. 1985;102(4):529–537. doi: 10.7326/0003-4819-102-4-529. PubMed DOI

Watkins K, Wood H, Schneider CR, Clifford R. Effectiveness of implementation strategies for clinical guidelines to community pharmacy: a systematic review. Implement Sci. 2015;10:151. doi: 10.1186/s13012-015-0337-7. PubMed DOI PMC

Curtain C, Peterson GM. Review of computerized clinical decision support in community pharmacy. J Clin Pharm Ther. 2014;39(4):343–348. doi: 10.1111/jcpt.12168. PubMed DOI

Osheroff JA, Teich JM, Middleton B, Steen EB, Wright A, Detmer DE. A roadmap for national action on clinical decision support. J Am Med Inform Assoc. 2007;14(2):141–145. doi: 10.1197/jamia.M2334. PubMed DOI PMC

Mazoue JG. Diagnosis without doctors. J Med Philos. 1990;15(6):559–579. doi: 10.1093/jmp/15.6.559. PubMed DOI

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