Development and validation of a clinical and computerised decision support system for management of hypertension (DSS-HTN) at a primary health care (PHC) setting.
<h4>Background</h4>Hypertension remains the top global cause of disease burden. Decision support systems (DSS) could provide an adequate and cost-effective means to improve the management of hypertension at a primary health care (PHC) level in a developing country, nevertheless evidence...
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2013-01-01
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| Online Access: | https://doi.org/10.1371/journal.pone.0079638 |
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| author | Raghupathy Anchala Emanuele Di Angelantonio Dorairaj Prabhakaran Oscar H Franco |
| author_facet | Raghupathy Anchala Emanuele Di Angelantonio Dorairaj Prabhakaran Oscar H Franco |
| author_sort | Raghupathy Anchala |
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| description | <h4>Background</h4>Hypertension remains the top global cause of disease burden. Decision support systems (DSS) could provide an adequate and cost-effective means to improve the management of hypertension at a primary health care (PHC) level in a developing country, nevertheless evidence on this regard is rather limited.<h4>Methods</h4>Development of DSS software was based on an algorithmic approach for (a) evaluation of a hypertensive patient, (b) risk stratification (c) drug management and (d) lifestyle interventions, based on Indian guidelines for hypertension II (2007). The beta testing of DSS software involved a feedback from the end users of the system on the contents of the user interface. Software validation and piloting was done in field, wherein the virtual recommendations and advice given by the DSS were compared with two independent experts (government doctors from the non-participating PHC centers).<h4>Results</h4>The overall percent agreement between the DSS and independent experts among 60 hypertensives on drug management was 85% (95% CI: 83.61-85.25). The kappa statistic for overall agreement for drug management was 0.659 (95% CI: 0.457-0.862) indicating a substantial degree of agreement beyond chance at an alpha fixed at 0.05 with 80% power. Receiver operator curve (ROC) showed a good accuracy for the DSS, wherein, the area under curve (AUC) was 0.848 (95% CI: 0.741-0.948). Sensitivity and specificity of the DSS were 83.33 and 85.71% respectively when compared with independent experts.<h4>Conclusion</h4>A point of care, pilot tested and validated DSS for management of hypertension has been developed in a resource constrained low and middle income setting and could contribute to improved management of hypertension at a primary health care level. |
| format | Article |
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| institution | Kabale University |
| issn | 1932-6203 |
| language | English |
| publishDate | 2013-01-01 |
| publisher | Public Library of Science (PLoS) |
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| series | PLoS ONE |
| spelling | doaj-art-fdf29e81c1ea418ea6635f6cafaebceb2025-08-20T03:46:23ZengPublic Library of Science (PLoS)PLoS ONE1932-62032013-01-01811e7963810.1371/journal.pone.0079638Development and validation of a clinical and computerised decision support system for management of hypertension (DSS-HTN) at a primary health care (PHC) setting.Raghupathy AnchalaEmanuele Di AngelantonioDorairaj PrabhakaranOscar H Franco<h4>Background</h4>Hypertension remains the top global cause of disease burden. Decision support systems (DSS) could provide an adequate and cost-effective means to improve the management of hypertension at a primary health care (PHC) level in a developing country, nevertheless evidence on this regard is rather limited.<h4>Methods</h4>Development of DSS software was based on an algorithmic approach for (a) evaluation of a hypertensive patient, (b) risk stratification (c) drug management and (d) lifestyle interventions, based on Indian guidelines for hypertension II (2007). The beta testing of DSS software involved a feedback from the end users of the system on the contents of the user interface. Software validation and piloting was done in field, wherein the virtual recommendations and advice given by the DSS were compared with two independent experts (government doctors from the non-participating PHC centers).<h4>Results</h4>The overall percent agreement between the DSS and independent experts among 60 hypertensives on drug management was 85% (95% CI: 83.61-85.25). The kappa statistic for overall agreement for drug management was 0.659 (95% CI: 0.457-0.862) indicating a substantial degree of agreement beyond chance at an alpha fixed at 0.05 with 80% power. Receiver operator curve (ROC) showed a good accuracy for the DSS, wherein, the area under curve (AUC) was 0.848 (95% CI: 0.741-0.948). Sensitivity and specificity of the DSS were 83.33 and 85.71% respectively when compared with independent experts.<h4>Conclusion</h4>A point of care, pilot tested and validated DSS for management of hypertension has been developed in a resource constrained low and middle income setting and could contribute to improved management of hypertension at a primary health care level.https://doi.org/10.1371/journal.pone.0079638 |
| spellingShingle | Raghupathy Anchala Emanuele Di Angelantonio Dorairaj Prabhakaran Oscar H Franco Development and validation of a clinical and computerised decision support system for management of hypertension (DSS-HTN) at a primary health care (PHC) setting. PLoS ONE |
| title | Development and validation of a clinical and computerised decision support system for management of hypertension (DSS-HTN) at a primary health care (PHC) setting. |
| title_full | Development and validation of a clinical and computerised decision support system for management of hypertension (DSS-HTN) at a primary health care (PHC) setting. |
| title_fullStr | Development and validation of a clinical and computerised decision support system for management of hypertension (DSS-HTN) at a primary health care (PHC) setting. |
| title_full_unstemmed | Development and validation of a clinical and computerised decision support system for management of hypertension (DSS-HTN) at a primary health care (PHC) setting. |
| title_short | Development and validation of a clinical and computerised decision support system for management of hypertension (DSS-HTN) at a primary health care (PHC) setting. |
| title_sort | development and validation of a clinical and computerised decision support system for management of hypertension dss htn at a primary health care phc setting |
| url | https://doi.org/10.1371/journal.pone.0079638 |
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