Development and Effectiveness of a Clinical Decision Support System for Postembolization Syndrome after Transarterial Chemoembolization: A Randomized Controlled Trial

Based on the frequency of postembolization syndrome (PES) after transarterial chemoembolization (TACE), early detection and management of symptoms should be standardized and can be supported by a clinical decision support system (CDSS). This study aims to develop a CDSS for PES after TACE and evaluate its effectiveness. CDSS was developed through phases of intelligence, design, selection, and implementation using machine learning. A randomized controlled trial with a non-synchronized pre- and post-test was employed to test its effectiveness. Interventions included a handbook developed by the researchers for the control group (n = 8) and a smartphone-based CDSS for PES management as well as the handbook for the experimental group (n = 10) for 6 weeks. Symptom management and barriers, patient-centered caring attitude, and comfort care competence were evaluated at pre-intervention, immediately post-intervention, and 8 weeks post-intervention. Data were analyzed using descriptive statistics, Mann-Whitney U, chi-square, Fisher exact tests, and repeated measures ANOVA. The CDSS primarily exhibited the ability to provide risk prediction for PES and care recommendations for symptom management. The evaluation of the CDSS effects revealed that while it changed nursing practice over a relatively short period of time, it did not change attitudes or competencies. This study demonstrated that the machine learning-based CDSS improved decision-making accuracy and efficiency in clinical settings. The development and implementation of the CDSS can offer nurses a tangible tool to enhance symptom management and reduce barriers for patients receiving TACE. KCT0008888 in the Clinical Research Information Service.(2023.10/20).