Leveraging electronic medical records to evaluate a computerized decision support system for staphylococcus bacteremia
Infectious disease specialists (IDS) improve outcomes of patients with Staphylococcus bacteremia, but immediate IDS access is not always guaranteed. We investigated whether a care-integrated computerized decision support system (CDSS) can safely enhance the standard of care (SOC) for these patients. We conducted a multicenter, noninferiority, interventional stepped-wedge cluster randomized controlled trial relying on the data integration centers at five university hospitals. By this means, electronic medical records can be used for part of the trial documentation. We analyzed 5056 patients from 134 wards (Staphylococcus aureus (SAB): n = 812, coagulase-negative staphylococci (CoNS): n = 4244) and found that the CDSS was noninferior to the SOC for hospital mortality in all patients. Noninferiority regarding the 90-day mortality/relapse in SAB patients was not observed and there was no evidence for differences in vancomycin usage among CoNS patients. Despite low reported usage, physicians rated the CDSS's usability favorably. Trial registration: drks.de; Identifier: DRKS00014320; Registration Date: 2019-05-06.
Authors
- Frauke Kretzschmann
- André Scherag (ORCID: https://orcid.org/0000-0002-9406-4704)
- Lo An Phan-Vogtmann
- Jonas Renz
- Julia Palm (ORCID: https://orcid.org/0000-0003-1568-5893)
- Norman Lippmann (ORCID: https://orcid.org/0000-0002-6420-426X)
- Anne-Kathrin Hartig
- Ariadna Pérez Garriga (ORCID: https://orcid.org/0000-0001-8840-1770)
- Thomas Wendt (ORCID: https://orcid.org/0000-0002-5319-0587)
- Rainer Röhrig (ORCID: https://orcid.org/0000-0002-0032-5118)
- Abel Stolz
- Eric J. Thomas (ORCID: https://orcid.org/0000-0002-3656-9181)
- Kutaiba Saleh
- Andrew J. Stempel
- Henner Kruse (ORCID: https://orcid.org/0000-0003-0286-8682)
- Mario Popp
- Christoph Müller (ORCID: https://orcid.org/0000-0002-3829-8223)
- Kristin Friebel
- Margarethe Konik
- S Kahle
- Danny Ammon (ORCID: https://orcid.org/0000-0001-8960-7316)
- Ssuhir Alaid
- Petra Hetfeld
- Cord Spreckelsen (ORCID: https://orcid.org/0000-0002-7301-1566)
- Stefan Hagel (ORCID: https://orcid.org/0000-0003-2999-6131)
- Gernot Marx (ORCID: https://orcid.org/0000-0003-0866-4234)
- Mathias Wilhelm Pletz (ORCID: https://orcid.org/0000-0001-8157-2753)
- Andreas Dürschmid
- Christoph Lübbert (ORCID: https://orcid.org/0000-0001-6942-5785)
- Susanne Thon (ORCID: https://orcid.org/0009-0004-0254-2935)
- Daniel Tiller
- Sebastian Wendt (ORCID: https://orcid.org/0000-0002-6775-3686)
- Jonas Fortmann (ORCID: https://orcid.org/0000-0003-1757-525X)
- Stefan Moritz (ORCID: https://orcid.org/0000-0001-9503-9642)
- Rafael Mikolajczyk (ORCID: https://orcid.org/0000-0003-1271-7204)
- Florian Rißner
- Oliver Witzke (ORCID: https://orcid.org/0000-0002-1019-1301)
- Andrew J Heidel
- Julian Brandes
- Roland Ihle (ORCID: https://orcid.org/0000-0002-8502-7303)
- Sebastian Uschmann (ORCID: https://orcid.org/0000-0003-3108-6495)
- Verena Koi
- Dalin He (ORCID: https://orcid.org/0000-0002-8099-146X)
- Claudia Fischer (ORCID: https://orcid.org/0000-0001-8552-5612)
- Susanne Müller
- Diana Pietzner
- Sebastian Schönherr
- Philipp Winnekens
- Anne Mlocek
- Maike Rebenstorff
- Sarah Geihs
Institutions
- Essen University Hospital (DE)
- Universitätsklinikum Aachen (DE)
- University Hospital Leipzig (DE)
- Jena University Hospital (DE)
- University Hospital in Halle (DE)
- Martin Luther University Halle-Wittenberg (DE)
- Friedrich Schiller University Jena (DE)
- RWTH Aachen University (DE)
- Leipzig University (DE)
Publication Details
- Journal
- npj Digital Medicine
- Published
- 2025-03-28
- DOI
- https://doi.org/10.1038/s41746-025-01569-3
- Citations
- 2
- Primary Topic
- Bacterial Identification and Susceptibility Testing
- Type
- article
- Field-Weighted Citation Impact
- 2.64
Funders
- Bundesministerium für Bildung und Forschung