Applicability of Clinical Decision Support in Management among Patients Undergoing Cardiac Surgery in Intensive Care Unit: A Systematic Review
, Alexo López-Álvarez 1, Gerardo Baños 1, Alejandro Pazos 2,4 and Javier Pereira 3,4
Round 1
Reviewer 1 Report
Authors presenting interesting work of clinical decision support applications in ICU cardiac patients. However, I want to propose some suggestions to improve the manuscript.
- In the abstract, the literature search databases were missing
- Has this review registered on the PROSPERO platform?
- In a search strategy, medical subject headings (MeSH) need clearly described. How many subheadings the author was found for each search term?
- Also, some additional articles were found 140 through several literature reviews. “Several” means? Could you explain clearly?
- EBCOS host is misspelt EBSCO
- How authors defined included 22 articles are effective without conducting the quality assessment of selected items.
- Records excluded by Title and abstract are 301 it’s a sample. Just by checking title only authors not including means they did not include proper search terms this has to be seriously concerned for systematic reviews.
- Except for flaws in the methods part, the remaining sections are exceptionally written. I will forward to receive the amendments in methods.
Author Response
Dear reviewer,
We thank you for your valuable and useful contribution which are of great help to the improvement of our manuscript. We attach the responses to your comments.
Point 1. In the abstract, the literature search databases were missing
Response 1: Thank you for your comment. The authors added the literature search databases, marked in yellow, in the abstract (page 1, line 27).
Point 2. Has this review registered on the PROSPERO platform?
Response 2: Thank you for your suggestion. According to the reviewer, the authors consider the Prospero platform to be of interest. However, the review wasn’t registered because it was not taken into consideration at the appropriate time. Thus, the authors will take the Prospero platform into account in future systematic reviews.
Point 3. In a search strategy, medical subject headings (MeSH) need clearly described. How many subheadings the author was found for each search term?
Response 3: Thank you for your appreciation. The authors described the Mesh terms and subheadings in Appendix A, marked in yellow, on page 17.
The authors found three subheadings for "Intensive Care Units"; two subheadings for "Critical Care"; five subheadings for "Artificial Intelligence"; and one subheading for "Electronic Medical Records". The remaining search terms ("Clinical Decision Support Systems"; Computerized Physician Order Entry"; "Database"; "Cardiogenic Shock"; and "Post-Cardiac) didn't have any subheadings. You can see them in yellow on Appendix A, page 17.
Point 4. Also, some additional articles were found 140 through several literature reviews. “Several” means? Could you explain clearly?
Response 4: Thank you for your comment. The authors apologize for the confusion with the term "several" and the confusion in that paragraph. The authors wanted to explain that some papers about the review's topic were found through reviewing the bibliography section of full-text articles and systematic reviews. The authors modified this sentence in the manuscript. You can see it marked in yellow on page 3, lines 142-144.
Point 5. EBCOS host is misspelt EBSCO
Response 5: Thank you for your appreciation. The authors corrected this word. You can see it, marked in yellow, in Figure 1 on page 4.
Point 6. How authors defined included 22 articles are effective without conducting the quality assessment of selected items.
Response 6: Thank you for your comment. The articles included in the manuscript were subjected to some evaluation criteria. The authors based on previous systematic reviews that used the factors of the Effective Public Health Practice Project tool (EPHPP). The authors assessed some factors as selection bias, (b) study design, (c) confounders, (d) blinding, (e) data collection methods, and (f) withdrawal and drop-outs. You can see this information marked in yellow on page 5, lines 175-179.
Point 7. Records excluded by Title and abstract are 301 it’s a sample. Just by checking title only authors not including means they did not include proper search terms this has to be seriously concerned for systematic reviews.
Point 7: Thank you for your comment. The authors understand their concern about the exclusion of 301 articles based on their title and abstract. However, despite an exhaustive search in different databases through the keywords and Mesh terms used, 301 articles did not meet the selection criteria determined in this review after reading their abstract. You can see this information marked in yellow on page 4, lines 150-151.
Point 8. Except for flaws in the methods part, the remaining sections are exceptionally written. I will forward to receive the amendments in methods.
Response 8: Thank you for your appreciation. The authors hope to have solved the flaws in the methods part.
In addition, the authors used the Applied Sciences journal service of English Editing to ensure the quality of the writing. These changes are marked in yellow along with the manuscript.
Author Response File: 
Author Response.pdf
Reviewer 2 Report
Overall, this manuscript is well written. The authors conducted a literature review on the clinical decision support systems and provided informative summary of the findings from the literature.
I have a few minor comments:
The authors provided plenty of background information about different CDSS in the Introduction section. However, it is somewhat difficult to follow, as the authors presented it in too many short paragraphs. Please reorganize the Introduction section, having a few subsections by themes would improve the readability.
For Table 1, it will be better to have the headers repeated on different pages.
In line 214, “Jalali et al” should be “Jalali et al.” (with the dot after al) The same error can be found throughout the paper.
Author Response
Dear reviewer,
We thank you for your valuable and useful contribution which are of great help to the improvement of our manuscript. We attach the responses to your comments.
Point 1. Overall, this manuscript is well written. The authors conducted a literature review on the clinical decision support systems and provided informative summary of the findings from the literature.
Response 1: Thank you for your comments and appreciation.
I have a few minor comments:
Point 2. The authors provided plenty of background information about different CDSS in the Introduction section. However, it is somewhat difficult to follow, as the authors presented it in too many short paragraphs. Please reorganize the Introduction section, having a few subsections by themes would improve the readability.
Response 2: Thank you for your suggestion. The authors reorganized the introduction section, including some section as "Background of decision support systems" and "Objectives". You can see it, marked in yellow, on pages 2-3.
Point 3. For Table 1, it will be better to have the headers repeated on different pages.
Response 3: Thank you for your suggestion. The authors added the headers on the different pages, where is Table 1. You can see them, marked in yellow, on pages 6-11.
Point 4. In line 214, “Jalali et al” should be “Jalali et al.” (with the dot after al) The same error can be found throughout the paper.
Response 4: Thank you for your comment. The authors corrected this error throughout the manuscript. You can see these changes are marked in yellow throughout the manuscript.
In addition, the authors used the Applied Sciences journal service of English Editing to ensure the quality of the writing. These changes are marked in yellow along with the manuscript.
Author Response File: Author Response.pdf
