Clinical Decision Support Systems: An Innovative Approach to Enhancing Child and Adolescent Mental Health Services

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In the “good old days,” Hippocrates narrowed the basic understanding of disease and
clinical practice to four “humors”: blood, phlegm, yellow bile and black bile. Today,
medical practice takes place in a rapidly expanding realm of an ever-changing knowledge
base that makes it difficult to include all evidence-based information about etiology,
epidemiology, phenomenology, assessment, prevention, treatment, and more, in day-to-day
patient care. This is made more challenging by the complexity and growing interest
in “personalized medicine” and “precision medicine.” While some clinicians read widely
and have prodigious memories, few of us are able to apply all available, pertinent
knowledge to our patients’ care. We do have options. We can revert to the four humors.
Better yet, we can look for modern technology to support complex clinical practice
with computer capacity and artificial intelligence. These innovative processes have
been captured for clinical use in what is referred to as Clinical Decision Support
Systems (CDSSs).

Article Info

Publication History

Publication stage

In Press Journal Pre-Proof

Footnotes

Funding was received from the Norwegian Research Council (269117).

Author Contributions

Conceptualization: Clausen, Leventhal, Skokauskas

Supervision: Leventhal, Nytrø, Skokauskas

Visualization: Nytrø, Skokauskas

Writing – original draft: Clausen, Skokauskas

Writing – review and editing: Clausen, Leventhal, Nytrø, Koposov, Westbye, Røst, Bakken, Koochakpour, Thorvik, Skokauskas

Disclosure: Dr. Leventhal has received support from Janssen/JandJ and has served on the CMI Scientific Advisory Board. Dr. Nytrø, Profs. Koposov and Skokauskas, Ms. Clausen, Messrs. Westbye and Røst, Mss. Bakken and Koochakpour, and Mr. Thorvik have reported no biomedical financial interests or potential conflicts of interest.

Several trade names are mentioned in the paper. Deontics is decision software used in the IDDEAS project. OncoDoc2, CHICA and Google Convolutional Neural

Networks are cited simply to provide examples for the reader to explore if they are interested. The name IDDEAS belongs to the Norwegian Consortium developing a children and adolescent mental health clinical decision support system. It is not a commercial product.

Identification

DOI: https://doi.org/10.1016/j.jaac.2020.09.018

Copyright

© 2020 Published by Elsevier Inc. on behalf of the American Academy of Child and Adolescent Psychiatry.

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