Clinical calculators in hospital medicine: Availability, classification, and needs

doi:10.1016/j.cmpb.2016.05.006

Computer Methods and Programs in Biomedicine

Volume 133, September 2016, Pages 1-6

https://doi.org/10.1016/j.cmpb.2016.05.006 Get rights and content

Highlights

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Validated clinical calculators and scores serve as useful clinical tools in practice.
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There is no information about quantity, their distribution by clinical specialties, and their need.
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Readily available clinical calculators were identified, classified and attributed to clinical specialties.
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Institution-specific usefulness of clinical calculators was evaluated.

Abstract

Objective

Clinical calculators are widely used in modern clinical practice, but are not generally applied to electronic health record (EHR) systems. Important barriers to the application of these clinical calculators into existing EHR systems include the need for real-time calculation, human–calculator interaction, and data source requirements. The objective of this study was to identify, classify, and evaluate the use of available clinical calculators for clinicians in the hospital setting.

Methods

Dedicated online resources with medical calculators and providers of aggregated medical information were queried for readily available clinical calculators. Calculators were mapped by clinical categories, mechanism of calculation, and the goal of calculation. Online statistics from selected Internet resources and clinician opinion were used to assess the use of clinical calculators.

Results

One hundred seventy-six readily available calculators in 4 categories, 6 primary specialties, and 40 subspecialties were identified. The goals of calculation included prediction, severity, risk estimation, diagnostic, and decision-making aid. A combination of summation logic with cutoffs or rules was the most frequent mechanism of computation. Combined results, online resources, statistics, and clinician opinion identified 13 most utilized calculators.

Conclusion

Although not an exhaustive list, a total of 176 validated calculators were identified, classified, and evaluated for usefulness. Most of these calculators are used for adult patients in the critical care or internal medicine settings. Thirteen of 176 clinical calculators were determined to be useful in our institution. All of these calculators have an interface for manual input.

Section snippets

Background

Clinical calculators are widely used in modern clinical practice, but are not generally applied to electronic medical record (EHR) systems. One reason for widespread use of clinical calculators in modern clinical practice is increased ease of accessibility to computers, including desktops, laptops, smartphones, and tablet/handheld computers [1]. Other potential reasons include: the reliance of evidence medicine-based practice on quantitative metrics to guide decision making (e.g. CHADS score

Study design and setting

This is an observational study performed at Mayo Clinic in Rochester, Minnesota. This study was exempted from institutional review board approval.

Data sources

Dedicated online resources with clinical calculators and providers of aggregated medical information were used (UpToDate, Merck/Univadis, and Medscape) [12], [13], [14]. Names of available clinical calculators were extracted. Resources and web pages hosted on anonymous platforms (without references, contact information and disclaimers), containing a

Results

More than 100 resources were identified, but only 28 met inclusion criteria (Fig. 1). Extraction of available calculators supplied us with 371 tools. One hundred ninety-five were excluded because they used simple formulae, equations, or conversion mechanisms.

For all 176 extracted calculators, a primary and validating source was available in PubMed. All identified calculators were defined in four categories, resulting in 63 groups. The majority of studied calculators were designated for the

Discussion

One hundred seventy-nine readily available clinical calculators were identified, based on scores, rules, and criteria validated in clinical settings. The majority of calculators were dedicated for adult population and critical care settings. Based on combined clinician opinion and online statistics, 13 of 176 clinical calculators were prioritized. All of these calculators have an online interface for manual input.

Clinical calculators are tools for automated mathematical computations in the

Conclusion

Available clinical calculators for clinicians in the hospital setting were identified, classified, and evaluated for usefulness. Most of these calculators are used for adult patients in the critical care or internal medicine settings. Based on combined clinician opinion and online statistics, 13 of 176 clinical calculators were determined to be useful in the participating institution. All of these calculators have an interface for manual input. Multispecialty and multi-institutional studies are

Acknowledgments

We thank Andrew M. Harrison for his help. David McAuley (globalrph.com), Peter Bonis (uptodate.com), Louis Leff and Pascal Pfiffner (medcalc.medserver.be), Darryl Chemel (pharmainsight.ca), Sean Kane (ClinCalc.com), and Mark Morgan (soapnote.org) provided information about their resources with clinical calculators. This research received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors. Authors have no competing interests.

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View full text

Clinical calculators in hospital medicine: Availability, classification, and needs

Highlights

Abstract

Objective

Methods

Results

Conclusion

Section snippets

Background

Study design and setting

Data sources

Results

Discussion

Conclusion

Acknowledgments

J. Biomed. Inform

Mayo Clin. Proc

J. Biomed. Inform

Use of handheld computers in clinical practice: a systematic review

BMC Med. Inform. Decis. Mak

An algorithmic approach to clinical decision making

Oncol. Nurs. Forum

Outcomes of an algorithmic approach to treating mild ocular alkali burns

JAMA Ophthalmol

Diffuse lung disease of infancy: a pattern-based, algorithmic approach to histological diagnosis

J. Clin. Pathol

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Orthopedics

Information technology in critical care: review of monitoring and data acquisition systems for patient care and research

ScientificWorldJournal

Physician decision-making—evaluation of data used in a computerized ICU

Int. J. Clin. Monit. Comput

Clinical calculators for hand-held computers

Can. Fam. Physician

Preventing provider errors: online total parenteral nutrition calculator

Pediatrics

A systematic review of healthcare applications for smartphones

BMC Med. Inform. Decis. Mak

Tablet computers with mobile electronic medical records enhance clinical routine and promote bedside time: a controlled prospective crossover study

J. Neurol

Retrieving clinical evidence: a comparison of PubMed and Google Scholar for quick clinical searches

J. Med. Internet Res

Medical literature searches: a comparison of PubMed and Google Scholar

Health Info. Libr. J.

Google Scholar versus PubMed in locating primary literature to answer drug-related questions

Ann. Pharmacother

Calculation Review

Acute and Critical Care Formulas and Laboratory Values

Criteria for assessing the quality of health information on the Internet

Am. J. Public Health