Clinical Decision Support System (CDSS)


MedicBK

New treatment options for cardiovascular diseases
MedicBK is a CDSS that is a Software available as a Web application or a Web service. It is a direct aid for clinical-decision making, when patient-specific characteristics and assessments from Electronic Health Records (EHRs) are matched to a computerized clinical knowledge database.

Patients usually have a lot of comorbidities, and clinicians have to know a huge number of medications as well as how they interact. Thus, in practice it can be difficult to treat a patient specially in a situation where a quick decision is required because a diagnosis must be done based on available data from libraries such as PubMed in addition to dozens of clinical guidelines.
The MedicBK system contains all the evidence-based medicine tools that directs and supports Guideline-Directed Medical Therapies (GMDT) strategies. CDSS uses individual patient characteristics (vital signs, medical history, lab results, and medication-related side effects) and automatically determines all the data needed to select personalized evidence-based medicine (EBM) treatments. The program calculates available drugs for each individual case with special algorithms dependent on the indirect comparison of efficacy and safety through the network meta-analysis. The algorithms are built on databases from relevant and high-quality randomized clinical trials.
The CDSS objective medical data for physicians
is based on all evidence-based medical tools for the review of personalized patient protocols
Identifies risk factors, absolute and relative contraindications, cautions
Considers previously prescribed therapy, lab tests, achievement of target thresholds in risk reduction

Сalculates risks of adverse events in a patient according to prognostic scales
Recommends personalized protocols for efficacy and safety of medications/interventions relevant to the patient
Clinical management
In a matter of minutes, the physician receives from the CDSS personalized protocols of drugs/interventions related to the patient based on objective medical statistics. The CDSS is designed to increase the utilization of guideline directed therapy. It helps minimize medical errors, save the doctor's time, reduce emotional burnout syndrome, achieve the best treatment goals and, as a result, reduce the cost of drug treatment and hospitalization.
Administrative functions
The CDSS can be cost-effective for health systems and health insurance companies by decreasing inpatient length-of-stay and suggesting the most effective medication alternatives. It is a tool for identifying high-risk patients, monitoring and adjusting therapy to achieve target values.
CDSS improves quality of care by
  • Formation of a follow-up plan
  • Drug procurement planning by patients' cohorts with assessment of the clinical and economic outcome of treatment
  • Improvement of patient's access and length of time for receiving treatment
  • Unification of the application of personalized GDMT
  • Data collection of Health Economics and Outcomes Research
Evaluation of indicators:
  • Completeness of performed medical examinations
  • Compliance of prescribed therapy with clinical guidelines
  • High risk patient stratification for monitoring and evaluating the effectiveness of secondary prevention
  • Optimal drugs for better treatment outcome of each patient cohort
CDSS tool can reduce adverse events like Strokes and MI (major causes of high mortality)

Now available treatment options: Arterial hypertension, Atrial fibrillation, Heart failure, Chronic Coronary Syndromes, Dyslipidaemias
The effectiveness of CDSS was evaluated in the clinical study INTELLECT
ClinicalTrials.gov Identifier: NCT04564118
https://doi.org/10.1016/j.hrthm.2021.06.1098
The MedicBK CDSS led to selection of more effective and safe treatment strategies and GDMT. Results of the INTELLECT study were reported at the Congress of the Russian Society of Cardiology (2021), Heart Failure Congress (2021), HRS Congress (2021), and ESC Congress (2021). Together with the Russian Society of Cardiology, we conducted an educational project aimed to increase the doctors' adherence to clinical guidelines by interactive demonstration of clinical cases in the CDSS. Six hundred seventy cardiologists and therapists took part in this educational project in 2021.
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It took research doctors experienced in Clinical Practice Guidelines and specialists in modelling and meta-analysis 3+ years to develop the current version of CDSS

А self-sufficient ecosystem was created for collecting quality Big Data in medicine, analyzing and training AI to select the best therapy for each patient
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