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Tools can be alerts, scoring systems, order sets, dashboards, questionnaires, educational materials, forms or templates to name but a few and, as such, the output of the review is highly heterogeneous.
Our study suggests that for pain assessment and management, decision support interventions should personalize alerting cut-off scores for individual patients, and monitor and track pain scores over time, linking alerts and recommendations for action with trends in the data, rather than reacting to single individual data points.
Almost a third of observation sets where an alerting aggregate score should have been generated did not have a score recorded.
One in six observations sets in which an alerting aggregate score was recorded did not contain vital signs that should have generated an alert.
Observation sets that should not have led to an alert but which had an alerting aggregate score recorded were more common in incomplete than complete observation sets (3.2% (118/3716) vs 0.9% (116/13 079), p<0.001).
As incomplete observation sets were also particularly likely to contain vital signs that should have led to an alerting aggregate score, errors in incomplete observation sets are particularly likely to affect patient care.
Incomplete data sets were more likely than complete data sets to contain observations that should have led to an alert (15.1% (560/3716) vs 7.6% (994/13 079), p<0.001), but less likely to have an appropriate alerting aggregate score recorded (61.3% (343/560) vs 70.0% (696/994), p<0.001).
