PONE-D-20-38355Towards Effective Clinical Decision Support Systems: A Systematic ReviewPLOS ONE

Dear Dr. Hak,

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Gabriele Oliva, Ph.D

Academic Editor

PLOS ONE

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Additional Editor Comments (if provided):

Two reviews were obtained, both suggesting minor edits to the paper. I agree with the reviewers' evaluation and I am recommending a minor revision of the paper.

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Reviewers' comments:

Reviewer's Responses to Questions

Comments to the Author

1. Is the manuscript technically sound, and do the data support the conclusions?

The manuscript must describe a technically sound piece of scientific research with data that supports the conclusions. Experiments must have been conducted rigorously, with appropriate controls, replication, and sample sizes. The conclusions must be drawn appropriately based on the data presented.

Reviewer #1: Partly

Reviewer #2: Partly

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2. Has the statistical analysis been performed appropriately and rigorously?

Reviewer #1: I Don't Know

Reviewer #2: I Don't Know

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3. Have the authors made all data underlying the findings in their manuscript fully available?

The PLOS Data policy requires authors to make all data underlying the findings described in their manuscript fully available without restriction, with rare exception (please refer to the Data Availability Statement in the manuscript PDF file). The data should be provided as part of the manuscript or its supporting information, or deposited to a public repository. For example, in addition to summary statistics, the data points behind means, medians and variance measures should be available. If there are restrictions on publicly sharing data—e.g. participant privacy or use of data from a third party—those must be specified.

Reviewer #1: Yes

Reviewer #2: Yes

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4. Is the manuscript presented in an intelligible fashion and written in standard English?

PLOS ONE does not copyedit accepted manuscripts, so the language in submitted articles must be clear, correct, and unambiguous. Any typographical or grammatical errors should be corrected at revision, so please note any specific errors here.

Reviewer #1: Yes

Reviewer #2: Yes

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5. Review Comments to the Author

Please use the space provided to explain your answers to the questions above. You may also include additional comments for the author, including concerns about dual publication, research ethics, or publication ethics. (Please upload your review as an attachment if it exceeds 20,000 characters)

Reviewer #1: The topic is quite relevant and important. Overall, the paper achieved its overall aim i.e. " to systematically review the extant empirical evidence on this topic, establish the status quo of the research, and propose an agenda for further studies" However, there are a number of issues with the methods and the reporting as documented below.

This paper provides an extensive literature review related to the key features that influences the development of effective CDSS.

Method:

• The authors argue that focused only on papers published in five online data sources. There are other resources such as valuable conferences that might be even more relevant to the study's purpose than those in grey literature.

• The search strategy is not comprehensive enough for a systematic review. The search strategy is apparently missing.

• In the information resources, it is stated that five online data sources that have a major impact on health information systems research were selected. On what basis are these five main sources (references)? Which reference (s)?

Discussion:

• The authors argue that none of the reviews have provided a global trend of a CDSS through a systematic review, but the reader might find this claim ambitious (Given that you have not searched the database anymore).

• In the discussion, in systematic review articles, the results of the article should be compared with other articles related to this paper.

The structuring of the discussion and conclusion presentation is not well-argued and not clear to me.

Please rewrite the conclusion. Start with the main findings which should contain an overview of the literature you studied.

Reviewer #2: The article carries out a systematic review of clinical decision support systems. In particular, they want to identify the articles dealing with this issue by highlighting the characteristics that distinguish them, also providing information on the purpose and the recipient.

Five open source online resources are considered. In addition, defined a methodology based on specific criteria: freely accessible articles, written in English, must provide medical support, media must be computer or technological. Two reviewers will analyze the title, abstract and keyword of the articles according to the parameters and will extract the most significant ones. The extracted elements will be read entirely and analyzed. In particular, four main features will be analyzed: the management and technical representations, technological characteristics of the system, the type of system and the integration of the system. The data were classified without providing an analysis of the analyzed characteristics and differences between the various solutions proposed. It also shows the trend of the distribution and the use of different methodologies not analyzing the data or providing a comment of the same.

Authors should express more clearly the choice of criteria and the analysis made. In addition, the differences and aspects highlighted by the collection should be highlighted and clarify.

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If you choose “no”, your identity will remain anonymous but your review may still be made public.

Do you want your identity to be public for this peer review? For information about this choice, including consent withdrawal, please see our Privacy Policy.

Reviewer #1: Yes: Maryam Zahmatkeshan

Reviewer #2: No

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Towards Effective Clinical Decision Support Systems: A Systematic Review

PONE-D-20-38355R1

Dear Dr. Hak,

We’re pleased to inform you that your manuscript has been judged scientifically suitable for publication and will be formally accepted for publication once it meets all outstanding technical requirements.

Within one week, you’ll receive an e-mail detailing the required amendments. When these have been addressed, you’ll receive a formal acceptance letter and your manuscript will be scheduled for publication.

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Kind regards,

Gabriele Oliva, Ph.D

Academic Editor

PLOS ONE

Additional Editor Comments (optional):

Both reviewers recommend acceptance. I agree with their judgement and I recommend acceptance as well.

Reviewers' comments:

Reviewer's Responses to Questions

Comments to the Author

1. If the authors have adequately addressed your comments raised in a previous round of review and you feel that this manuscript is now acceptable for publication, you may indicate that here to bypass the “Comments to the Author” section, enter your conflict of interest statement in the “Confidential to Editor” section, and submit your "Accept" recommendation.

Reviewer #1: All comments have been addressed

Reviewer #2: All comments have been addressed

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2. Is the manuscript technically sound, and do the data support the conclusions?

The manuscript must describe a technically sound piece of scientific research with data that supports the conclusions. Experiments must have been conducted rigorously, with appropriate controls, replication, and sample sizes. The conclusions must be drawn appropriately based on the data presented.

Reviewer #1: Yes

Reviewer #2: Yes

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3. Has the statistical analysis been performed appropriately and rigorously?

Reviewer #1: Yes

Reviewer #2: N/A

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4. Have the authors made all data underlying the findings in their manuscript fully available?

The PLOS Data policy requires authors to make all data underlying the findings described in their manuscript fully available without restriction, with rare exception (please refer to the Data Availability Statement in the manuscript PDF file). The data should be provided as part of the manuscript or its supporting information, or deposited to a public repository. For example, in addition to summary statistics, the data points behind means, medians and variance measures should be available. If there are restrictions on publicly sharing data—e.g. participant privacy or use of data from a third party—those must be specified.

Reviewer #1: Yes

Reviewer #2: Yes

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5. Is the manuscript presented in an intelligible fashion and written in standard English?

PLOS ONE does not copyedit accepted manuscripts, so the language in submitted articles must be clear, correct, and unambiguous. Any typographical or grammatical errors should be corrected at revision, so please note any specific errors here.

Reviewer #1: Yes

Reviewer #2: Yes

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6. Review Comments to the Author

Please use the space provided to explain your answers to the questions above. You may also include additional comments for the author, including concerns about dual publication, research ethics, or publication ethics. (Please upload your review as an attachment if it exceeds 20,000 characters)

Reviewer #1: Authors have adequately addressed my comments raised in a previous round of review and my feel that this manuscript is now acceptable for publication.

With respect

Reviewer #2: The article carries out a systematic review of clinical decision support systems. In particular, they want to identify the articles dealing with this issue by highlighting the characteristics that distinguish them, also providing information on the purpose and the recipient.

Five open source online resources are considered. In addition, defined a methodology based on specific criteria: freely accessible articles, written in English, must provide medical support, media must be computer or technological. Two reviewers will analyze the title, abstract and keyword of the articles according to the parameters and will extract the most significant ones. The extracted elements will be read entirely and analyzed. In particular, four main features will be analyzed: the management and technical representations, technological characteristics of the system, the type of system and the integration of the system. Authors express clearly the choice of criteria and the analysis made. In addition, the differences and aspects highlighted by the collection are express.

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7. PLOS authors have the option to publish the peer review history of their article (what does this mean?). If published, this will include your full peer review and any attached files.

If you choose “no”, your identity will remain anonymous but your review may still be made public.

Do you want your identity to be public for this peer review? For information about this choice, including consent withdrawal, please see our Privacy Policy.

Reviewer #1: No

Reviewer #2: No

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