Table 1 Study interventions

From: A systematic review of clinicians’ acceptance and use of clinical decision support systems over time

Timeframe	First author	Year	CDS type	Knowledge or non-knowledge based CDS	CDS target	CIS details and level of integration*
0–1 months	Castellanos¹⁶,^a	2018	Passive recommendations	Knowledge	Appropriate procalcitonin testing for sepsis	Off the shelf, unidirectional data exchange, embedded in CIS
0–1 months	Grauer¹⁷	2022	Interruptive alerts and indications	Knowledge	Indications for medication orders	Off the shelf, bidirectional, embedded
1–2 months	Castellanos¹⁶^,a	2018	(as above)
	Guidi¹⁸	2015	Interruptive alerts	Knowledge	Early warning system to detect patients at risk for sudden clinical deterioration and development of severe sepsis	Off the shelf, bidirectional, embedded in CIS
	Sauro¹⁹^,a	2019	Order set	Knowledge	Increase use of low molecular weight heparin for VTE prophylaxis	Off the shelf, bidirectional data exchange, embedded in CIS
	Tsai²⁰	2022	Dashboard	Non-knowledge	Monitoring prognostic risk across 8 different diseases	NR, unidirectional, NR
2–3 months	Castellanos¹⁶^,a	2018	(as above)
	DeBie²¹	2021	Dynamic checklist	Non-knowledge	Supporting ICU ward rounds	NR, unidirectional data exchange, NR
	Harrison²²	2017	Passive alerts	Non-knowledge	Detection of severe sepsis	Developed, bidirectional, embedded in CIS
	Petersen²³	2020	Report with risk stratification and recommendations	NR	Risk prediction of neonatal hyperbilirubinemia (jaundice) through bilirubin	Off the shelf, unidirectional data exchange, embedded in CIS
	Thayer²⁴	2021	Dashboard	Knowledge	Flag high risk asthma patients	Off the shelf, NR (at least unidirectional), embedded in CIS
3–4 months	Berge²⁵	2023	Filtered information in clinical documents	Non-knowledge (NLP)	Identifying and classifying patient allergies	NR, unidirectional data exchange, embedded
	Casey²⁶	2023	Risk assessment, report and passive alerts	Non-knowledge-based risk assessment, Knowledge report and passive alerts	Prediction of acute heart failure	Off the shelf, NR, embedded
	Chadwick²⁷	2017	Interruptive alerts	Knowledge	Prompt to add HIV test to an order	NR, bidirectional data exchange, embedded in CIS
	Huang²⁸	2020	Risk assessment and care bundle	Knowledge	Improve nursing care quality for pressure ulcers	NR, NR (some level of data exchange), NR
	Jenssen²⁹	2016	Passive alerts	Knowledge	Smoking cessation counselling and treatment for parents who smoke	Off the shelf, bidirectional data exchange, embedded in CIS
	Keim-Malpass³⁰^,a	2018	Risk assessment visualisation	Knowledge	Predictive monitoring and early detection of acute illness	Off the shelf, unidirectional, not embedded in CIS
	Mahabee-Gittens³¹^,a	2018	Passive prompts, interruptive alerts and order set	Knowledge	Tobacco smoke exposure screening and counselling for paediatric caregivers who smoke	Off the shelf, unidirectional data exchange, embedded in CIS
	Rosenthal³²	2019	Interruptive alerts and order set	Non-knowledge (NLP) triggered alerts and knowledge-based order set	Child physical abuse screening	Off the shelf, unidirectional data exchange, embedded in CIS
	Sauro¹⁹^,a	2019	(as above)
	Yoon³³	2023	Imaging detection	Non-knowledge	Detection of 8 abnormal findings in chest x-rays	NR, unidirectional, embedded
4–5 months	Feldstein³⁴	2023	Interruptive alerts and order set	Knowledge	Identification, evaluation and reporting of potential child abuse	Off the shelf, bidirectional data exchange, embedded
	Keim-Malpass³⁰^,a	2018	(as above)
	Mahabee-Gittens³¹^,a	2018	(as above)
	Suresh³⁵	2022	Interruptive alert and screening tool	Knowledge	Child abuse screening to identify child maltreatment	NR, bidirectional, embedded
5–6 months	Ginestra³⁶	2019	Interruptive alerts and text message alerts	Non-knowledge	Early warning system to predict severe sepsis or septic shock	NR, unidirectional data exchange, embedded in CIS
	Holroyd-Leduc³⁷	2010	Care pathway (strategies; orders; diagnostic tool) embedded in an order set	Knowledge	Delirium prevention among older hip fracture patients	NR, NR, embedded in CIS
	Rabinovich³⁸	2022	Imaging detection	Non-knowledge	Detection of pneumothorax, rib fracture, pleural effusion and lung opacities in chest x-rays	NR, NR, embedded
6–7 months	Bellodi³⁹	2017	Interruptive alerts (hard and soft stop)	Knowledge	Reduce lab test ordering	NR, bidirectional data exchange, embedded in CIS
	English⁴⁰	2017	Dashboard	NR	Real time surveillance of pharmaceutical therapies	NR, unidirectional data exchange, NR
	Hoekstra⁴¹	2010	Calculation and recommendations	Knowledge	Potassium regulation, recommendations for pump rate and next administration	NR, unidirectional data exchange, not embedded
	Jones⁴²	2019	Interruptive alerts and passive recommendations	Knowledge	ED diagnosis and management of pneumonia	NR, unidirectional data exchange, embedded in CIS
	Uppot⁴³	2022	Verbal checklist of targeted electronic health record data	Knowledge	Surgical safety/time-outs performed in ICU	Off the shelf, unidirectional data exchange, not embedded in CIS
7–12 months	Agostini⁴⁴	2008	Interruptive alerts	NR	Educational review and nonpharmacologic alternative recommendation to sedative hypnotic medications for insomnia	NR, unidirectional data exchange, embedded in CIS
	Bell⁴⁵	2019	Interruptive alerts	NR	Antibiotic review, VTE and allergies	Off the shelf, bidirectional data exchange, embedded in CIS
	Cho⁴⁶	2013	Dashboard and data entry form with predictive risk	Non-knowledge (Bayesian Network)	Reducing pressure ulcers	Developed, bidirectional data exchange, embedded in CIS
	Groshaus⁴⁷	2012	Order set	Knowledge	Preventing falls, functional decline and delirium among hospitalised older patients	NR, bidirectional, embedded in CIS
	Jauk⁴⁸	2021	Risk assessment visualisation	Non-knowledge	Delirium prediction	NR, unidirectional data exchange, embedded in CIS
	Lytle⁴⁹	2015	Interruptive alerts	Knowledge	Fall risk identification and prevention: incomplete assessment and high risk of falls/care plan alerts	Off the shelf, bidirectional data exchange, embedded in CIS
	Neame⁵⁰	2021	Interruptive alerts	Knowledge	Medication alerts: dose range checking	Off the shelf, bidirectional data exchange, embedded in CIS
	Nydert⁵¹	2017	Interruptive alerts	Knowledge	Medication alerts: dose calculation and dose range checking	NR, NR, embedded in CIS
	Pirnejad⁵²	2011	Order sets, calculation and recommendations	Knowledge	Chemotherapy protocols and dosing calculations	Developed, NR, embedded in CIS
	Salwei⁵³^,b	2021	Passive risk assessment and recommendations	Knowledge	Pulmonary embolism risk assessment and testing	NR, bidirectional data exchange, embedded in CIS
	Salwei⁵⁴^,b	2023	Passive risk assessment and recommendations	Knowledge	Pulmonary embolism risk assessment and testing	Off the shelf, bidirectional, embedded
	Stutman⁵⁵	2007	Interruptive alerts	Knowledge	Medication alerts: drug allergy, drug-drug interactions (critical only), duplicate medication checking and pregnancy and lactation	NR, bidirectional data exchange, embedded in CIS
	Henry⁵⁶	2022	Passive alert and risk assessment	Non-knowledge	Early warning system for timely identification and treatment of sepsis	Off the shelf, bidirectional, embedded
1–2 years	Bersani⁵⁷	2020	Dashboard with passive alerts	Knowledge	Patient safety, across 13 patient safety domains	Developed, bidirectional data exchange, embedded in CIS
	Eden⁵⁸	2020	Interruptive alerts	NR	Medication alerts: allergies and drug interactions	NR, bidirectional data exchange, embedded in CIS
	Frymoyer⁵⁹	2020	Dashboard	Non-knowledge	Precision dosing for vancomycin and therapeutic drug monitoring	Off the shelf, unidirectional data exchange, embedded in CIS
	Goldstein⁶⁰	2022	Interruptive alerts	Knowledge	Identify and refer patients with low vision	Off the shelf, bidirectional, embedded
	Hum⁶¹	2014	Dashboard and passive recommendations	Knowledge	Improving antibiotic prescribing through recommendations for empiric and targeted therapy	Off the shelf, bidirectional data exchange, embedded in CIS
	Salwei⁶²	2022	Passive risk assessment and recommendations	Knowledge	Pulmonary embolism risk assessment and testing	Off the shelf, bidirectional, embedded
	Scheepers-Hoeks⁶³	2013	Interruptive and passive alerts	Knowledge	Medication and intervention alerts: 13 clinical rules	Off the shelf, unidirectional data exchange, POC alerts embedded in CIS
	Short⁶⁴	2021	Order with calculations	Knowledge	Increase lung protective ventilation adherence for patients with acute respiratory distress syndrome	Off the shelf, bidirectional data exchange, embedded in CIS
	Zhai⁶⁵	2022	Templates and recommendations	Knowledge	Process-based documentation templates, diagnosis and intervention recommendations	NR, bidirectional, embedded
	Chow⁶⁶^,a	2016	Advice system and alerts	Knowledge	Antibiotic recommendations: type, dose and duration	NR, bidirectional data exchange, embedded in CIS
2–5 years	Campion⁶⁷	2011	Calculation and recommendation	Knowledge	Intensive insulin therapy dose recommendations to maintain blood glucose control	NR, unidirectional data exchange, embedded in CIS
	Chow⁶⁸^,b	2015	Advice system and alerts	Knowledge	Antibiotic recommendations: type, dose and duration	NR, NR, embedded in CIS
	Chow⁶⁶^,a,b	2016	(as above)
	Galanter⁶⁹	2010	Interruptive alerts	Knowledge	IV to oral therapy conversion	Off the shelf, bidirectional data exchange, embedded in CIS
	Lichtner⁷⁰	2020	Powerplan (order set), calculations and interruptive alerts	Knowledge	Chemotherapy prescription and administration, including dosing calculations	Off the shelf, NR, embedded in CIS
	Lin⁷¹	2010	Indications	Knowledge	Platelet transfusions	NR, NR, embedded in CIS
5+ years	Beeler⁷²	2016	Interruptive alerts	Knowledge	Medication alerts: medication allergies, DDIs, duplicate drugs, renal recommendations, age-based recommendations, and formulary substitutions	Developed, bidirectional data exchange, embedded in CIS
	Campion⁷³	2011	Calculation and recommendation	Knowledge	Intensive insulin therapy dose recommendations to maintain blood glucose control	NR, unidirectional data exchange, embedded in CIS
	Choi⁷⁴	2019	Interruptive alerts	Knowledge	Renal function drug dosing	NR, bidirectional data exchange, embedded in CIS
	Choudhury⁷⁵^,b	2022	Calculation and recommendations	Non-knowledge	Blood transfusions	NR, unidirectional, embedded in CIS
	Choudhury⁷⁶^,b	2023	Calculation and recommendations	Non-knowledge	Blood transfusions	NR, unidirectional, embedded in CIS
	Luna⁷⁷	2017	Interruptive alerts	NR	Medication alerts: DDIs	Developed, unidirectional data exchange, embedded in CIS
	Ng⁷⁸	2023	Interruptive and passive alerts	Knowledge	Range of best practice advisory alerts	Off the shelf, bidirectional, embedded
	Pontefract⁷⁹	2018	Order sets	NR	Medications (not further reported)	Developed, bidirectional, embedded in CIS
	Van De Sijpe⁸⁰	2022	Passive and interruptive alerts	Knowledge	Screening and alerting module for DDIs	Developed, bidirectional data exchange, embedded in CIS
	Wong⁸¹	2017	Interruptive alerts	Knowledge	Medication allergy, level 2 DDI alerts, geriatric and renal alerts	Developed, bidirectional data exchange, embedded in CIS
	Wright⁸²	2018	Interruptive, passive and hard-stop alerts	Knowledge	DDI alerts	Developed, bidirectional, embedded in CIS

CDS clinical decision support, CIS clinical information system, AI artificial intelligence, NR not reported, VTE venous thromboembolism, ICU Intensive care unit, HIV human immunodeficiency virus, NLP natural language processing, ED emergency department, IV intravenous, DDI drug-drug interaction.
*CIS details including commercial or developed CIS, level of data exchange between CIS and CDS, CDS embedded or not embedded within CIS, ^astudies separated for analysis of factors over time, ^bstudies combined for analysis of factors over time.

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Table 1 Study interventions

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