A systematic review of technologies and standards used in the development of rule-based clinical decision support systems

Abstract A Clinical Decision Support System (CDSS) is a technology platform that uses medical knowledge with clinical data to provide customised advice for an individual patient's care. CDSSs use rules encapsulate expert and engines infer logic by evaluating according specific information related facts. However, are nature complex plethora of different technologies, standards methods used implement them it can be difficult practitioners determine appropriate solution scenario. This study's main goal better understanding technical aspects CDSS, identify gaps in CDSS development ultimately some guidelines assist their translation into practice. We focus on issues representation including ontologies, interoperability EHRs, standards, architecture mobile/cloud access. study performs systematic literature review rule-based discuss the underlying technologies have evaluated outcomes. From search yielded initial set 1731 papers, only 15 included evaluation has found large majority papers did not include any form and, many evaluation, methodology was sufficiently rigorous statistically significant results. shortlisted, there were no RCT or quasi-experimental studies, 6 ontologies represent domain knowledge, 2 integrated EHR system, 5 supported mobile 3 recognised healthcare (and all these HL7 standards). Based findings, paper provides recommendations future development.