Clinical validation of clinical decision support systems for medication review: A scoping review

Birgit A. Damoiseaux-Volman, Stephanie Medlock, Delanie M. van der Meulen, Jesse de Boer, Johannes A. Romijn, Nathalie van der Velde, Ameen Abu-Hanna

Research output: Contribution to journalReview articleAcademicpeer-review

2 Citations (Scopus)


The aim of this scoping review is to summarize approaches and outcomes of clinical validation studies of clinical decision support systems (CDSSs) to support (part of) a medication review. A literature search was conducted in Embase and Medline. In total, 30 articles validating a CDSS were ultimately included. Most of the studies focused on detection of adverse drug events, potentially inappropriate medications and drug-related problems. We categorized the included articles in three groups: studies subjectively reviewing the clinical relevance of CDSS's output (21/30 studies) resulting in a positive predictive value (PPV) for clinical relevance of 4–80%; studies determining the relationship between alerts and actual events (10/30 studies) resulting in a PPV for actual events of 5–80%; and studies comparing output of CDSSs to chart/medication reviews in the whole study population (10/30 studies) resulting in a sensitivity of 28–85% and specificity of 42–75%. We found heterogeneity in the methods used and in the outcome measures. The validation studies did not report the use of a published CDSS validation strategy. To improve the effectiveness and uptake of CDSSs supporting a medication review, future research would benefit from a more systematic and comprehensive validation strategy.
Original languageEnglish
Pages (from-to)2035-2051
Number of pages17
JournalBritish journal of clinical pharmacology
Issue number5
Early online date2021
Publication statusPublished - May 2022


  • adverse drug events
  • clinical decision support systems
  • inappropriate prescriptions
  • validation studies

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