Validation of a Smartphone Application for Assessment of the Risk of Venous Thromboembolism in Medical Patients

Objective: To validate a smartphone application-based clinical decision support system (CDSS) for risk assessment of venous thromboembolism (VTE) in hospitalized medical patients. Setting: The medical department of a teaching hospital in Jeddah, Saudi Arabia. Participants: 97 patients, admitted to the medical ward during the month of December 2015. Aim of the study: A smart phone application based CDSS was developed to assess the risk of VTE in medical patients. Patient data were collected and risk of VTE was calculated simultaneously by the application and by an expert hematologist. The aim of the study was to determine agreement between both sources. Results: Ninety-seven patients, mean age 50 (19-92) and 51% (50) males were included. Forty-eight percent of patients were stratified as high-risk score based on CDSS compared to forty-seven percent based on expert opinion. There was a strong agreement between the CDSS and the expert hematologist opinion, on the indication and type of prophylaxis suggested for patients with a high-risk score (Chi square 86.7 and 155, p= 0.000, p=0.000, respectively). There was also an agreement with expert hematologist on the need for thromboprophylaxis as well as the type of prophylaxis (Chi square 86.7 and 1.55 respectively). Conclusion: Smartphone application-based CDSS shows a strong agreement with expert opinion for determination of VTE risk score in medical patients. Thus, the smart-phone based CDSS application has the potential to improve physician compliance with guidelines and reduce inappropriate use of thromboprophylaxis, therefore improving clinical care.