Challenges and insights from implementing clinical decision support systems for radiologic imaging: experience from the MIDAS trial
Abstract Clinical decision support systems (CDSSs) have been developed to give guidance for referring physicians to make appropriate decisions at the point of care. The MIDAS study, a multicenter cluster randomized trial at four German university hospitals, was designed to evaluate the effectiveness...
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SpringerOpen
2025-07-01
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| Series: | Insights into Imaging |
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| Online Access: | https://doi.org/10.1186/s13244-025-02027-0 |
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| author | Thomas Kroencke Stijntje W. Dijk Moritz C. Halfmann Claudia Wollny Joerg Barkhausen Olav Janssen Dimitris Rizopoulos M. G. Myriam Hunink |
| author_facet | Thomas Kroencke Stijntje W. Dijk Moritz C. Halfmann Claudia Wollny Joerg Barkhausen Olav Janssen Dimitris Rizopoulos M. G. Myriam Hunink |
| author_sort | Thomas Kroencke |
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| description | Abstract Clinical decision support systems (CDSSs) have been developed to give guidance for referring physicians to make appropriate decisions at the point of care. The MIDAS study, a multicenter cluster randomized trial at four German university hospitals, was designed to evaluate the effectiveness of a CDSS for imaging referral (ESR iGuide) in routine clinical care. Based on our experience within the MIDAS study, we aim to describe the hurdles and difficulties, as well as the various insights gained, in the process of implementing a CDSS in a clinical and research setting. To successfully implement a CDSS for imaging requests, it is essential to monitor and address technical issues, adapt local workflows, define the scope and content, and prioritize user experience and acceptance. Critical relevance statement By identifying and addressing the various technical, content-related, and workflow challenges, this article gives valuable insights to facilitate future implementations of the ESR iGuide and similar clinical decision support systems CDSSs for imaging orders. Trial registration number Approval from the Medical Ethics Review Committee was obtained under protocol numbers 20-069 (Augsburg), B 238/21 (Kiel), 20-318 (Lübeck) and 2020-15125 (Mainz). The trial is registered in the ClinicalTrials.gov register under registration number NCT05490290. Key Points This manuscript reviews the challenges of implementing a clinical decision support system (CDSS) (ESR iGuide). Clinical implementation of a CDSS for imaging requests requires monitoring and adjustments in technical issues, local workflow, scope and content, and attention to user experience and acceptance. Our experience may equip stakeholders with the knowledge to proactively address these challenges. Graphical Abstract |
| format | Article |
| id | doaj-art-e3cdae97cdc440fe9b8a3d935185dcb7 |
| institution | Kabale University |
| issn | 1869-4101 |
| language | English |
| publishDate | 2025-07-01 |
| publisher | SpringerOpen |
| record_format | Article |
| series | Insights into Imaging |
| spelling | doaj-art-e3cdae97cdc440fe9b8a3d935185dcb72025-08-20T03:38:18ZengSpringerOpenInsights into Imaging1869-41012025-07-0116111310.1186/s13244-025-02027-0Challenges and insights from implementing clinical decision support systems for radiologic imaging: experience from the MIDAS trialThomas Kroencke0Stijntje W. Dijk1Moritz C. Halfmann2Claudia Wollny3Joerg Barkhausen4Olav Janssen5Dimitris Rizopoulos6M. G. Myriam Hunink7Department of Diagnostic and Interventional Radiology, University Hospital AugsburgDepartment of Radiology and Nuclear Medicine, Erasmus MC University Medical CenterDepartment of Radiology, University Medical Center MainzDepartment of Diagnostic and Interventional Radiology, University Hospital AugsburgDepartment of Radiology and Nuclear Medicine, University Medical Center Schleswig-Holstein (UKSH)Department of Radiology and Neuroradiology, University Medical Center Schleswig-Holstein (UKSH)Department of Epidemiology and Biostatistics, Erasmus MC University Medical CenterDepartment of Radiology and Nuclear Medicine, Erasmus MC University Medical CenterAbstract Clinical decision support systems (CDSSs) have been developed to give guidance for referring physicians to make appropriate decisions at the point of care. The MIDAS study, a multicenter cluster randomized trial at four German university hospitals, was designed to evaluate the effectiveness of a CDSS for imaging referral (ESR iGuide) in routine clinical care. Based on our experience within the MIDAS study, we aim to describe the hurdles and difficulties, as well as the various insights gained, in the process of implementing a CDSS in a clinical and research setting. To successfully implement a CDSS for imaging requests, it is essential to monitor and address technical issues, adapt local workflows, define the scope and content, and prioritize user experience and acceptance. Critical relevance statement By identifying and addressing the various technical, content-related, and workflow challenges, this article gives valuable insights to facilitate future implementations of the ESR iGuide and similar clinical decision support systems CDSSs for imaging orders. Trial registration number Approval from the Medical Ethics Review Committee was obtained under protocol numbers 20-069 (Augsburg), B 238/21 (Kiel), 20-318 (Lübeck) and 2020-15125 (Mainz). The trial is registered in the ClinicalTrials.gov register under registration number NCT05490290. Key Points This manuscript reviews the challenges of implementing a clinical decision support system (CDSS) (ESR iGuide). Clinical implementation of a CDSS for imaging requests requires monitoring and adjustments in technical issues, local workflow, scope and content, and attention to user experience and acceptance. Our experience may equip stakeholders with the knowledge to proactively address these challenges. Graphical Abstracthttps://doi.org/10.1186/s13244-025-02027-0Clinical decision support systemsOverdiagnosisReferralHealthcare costsRadiology |
| spellingShingle | Thomas Kroencke Stijntje W. Dijk Moritz C. Halfmann Claudia Wollny Joerg Barkhausen Olav Janssen Dimitris Rizopoulos M. G. Myriam Hunink Challenges and insights from implementing clinical decision support systems for radiologic imaging: experience from the MIDAS trial Insights into Imaging Clinical decision support systems Overdiagnosis Referral Healthcare costs Radiology |
| title | Challenges and insights from implementing clinical decision support systems for radiologic imaging: experience from the MIDAS trial |
| title_full | Challenges and insights from implementing clinical decision support systems for radiologic imaging: experience from the MIDAS trial |
| title_fullStr | Challenges and insights from implementing clinical decision support systems for radiologic imaging: experience from the MIDAS trial |
| title_full_unstemmed | Challenges and insights from implementing clinical decision support systems for radiologic imaging: experience from the MIDAS trial |
| title_short | Challenges and insights from implementing clinical decision support systems for radiologic imaging: experience from the MIDAS trial |
| title_sort | challenges and insights from implementing clinical decision support systems for radiologic imaging experience from the midas trial |
| topic | Clinical decision support systems Overdiagnosis Referral Healthcare costs Radiology |
| url | https://doi.org/10.1186/s13244-025-02027-0 |
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