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124 Abtahi et al. | Journal of Clinical and Translational Research 2024; 10(2): 119-140
Table 2. Characteristics of the panelists of the published studies have focused on specific domains of the
Domain Frequency (relative to the Range patient’s condition, whereas different possible aspects of clinical
total domain frequency [%]) decision-making were considered in the present study. The study by
Gender Pijls et al. [38] focused solely on the demographic factors influencing
Male 7 (70) N/A the severity of COVID-19. In contrast, we investigated a wide range
Female 3 (30) of clinical factors that could be effective in inpatient assessment.
Specialty The results of our study could support the policymakers in
Pulmonology 1 (10) N/A preparing the required equipment, such as an oximeter and
Anesthesia and intensivist 1 (10) mechanical ventilation. The oximeter should be accessible for
Emergency medicine 2 (20) patient monitoring in the ward and at home. In addition, a Bluetooth
Pharmacotherapy 1 (10) pulse oximeter with a telehealth system via mobile platforms can
Obstetrics and gynecology 1 (10) be used to check a patient’s condition as SpO is a critical factor
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Otorhinolaryngology 1 (10) for decision-making in most domains [39]. Therefore, an effective
General practice 3 (30) patient management strategy can be developed by prioritizing the
Clinical experience (years) critical factors and subsequently the essential factors.
<10 4 (40) 5 – 35 Medical history was recognized as a critical factor in our survey.
11 – 20 3 (30) years Consequently, timely access to the patient’s medical records could
21 – 30 1 (10) improve clinical decisions about the patient’s condition. Current
electronic health records (EHRs) can provide timely information
>30 2 (20)
Number of COVID-19 patients and real-time monitoring for the early detection and management
visited by the participant of severe diseases [40]. Given the COVID-19 pandemic, several
<50 3 (30) 10 – 2000 health-care organizations have rapidly implemented EHRs in their
50 – 150 4 (40) hospitals to improve patient safety management [41,42].
151 – 300 1 (10) Likewise, the lack of evidence-based recommendations
300 – 450 0 has led to clinicians having to review a vast amount of clinical
>450 2 (20) information just to manage the patients better. Nonetheless, the
high rate of infected patients is a major challenge for healthcare
providers [43]. In response, several researchers have developed
creatinine (Cr), serum Cr, GFR, SpO , and PaO . The critical decision-aid tools to address the issue [44,45].
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factors of the six outcomes are displayed in Table 3.
4.3. Recommendations for future studies
4. Discussion
This survey could account for the initial step of developing
4.1. Purpose of the study clinical decision support systems (CDSSs) for decision-making
Due to the complex nature of COVID-19, identifying the effective based on disease severity to aid physicians in making more
factors of decision-making for patient outcomes is an essential accurate decisions within a shorter time [46]. In this regard,
requirement of the current healthcare systems. Through this survey, Sherimon et al. developed a CDSS to combat COVID-19 in
primary healthcare to aid clinicians with real-time diagnosis [47].
the effective factors were identified with a combination of literature Despite the effectiveness of such systems, the development process
review and expert consensus. As patients experience different is complex and comprises different stages. Moreover, the early
symptoms after COVID-19 infection, all possible factors should be stages of CDSS development commonly involve determining the
considered for appropriate treatment and accurate clinical decision- minimum data sets, as was conducted in this study.
making at each COVID-19 progression stage. Hence, the results were From the point of view of clinical experts, this study
presented based on different stages in the decision-making process. investigated the effective demographic and clinical factors of

4.2. Brief information about the key findings common COVID-19 outcomes. However, this study did not
account for cultural and climatic factors that may also effectively
Among the critical factors, SpO was implicated in five out of affect patient outcomes, warranting further investigation of these
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the six decision-making outcomes for COVID-19 cases. Evidence factors in future studies.
has revealed that low blood oxygen or hypoxia is a warning SARS-CoV-2, the pathogen that causes COVID-19, is still
sign of severe COVID-19, correlating to the severity of the spreading rapidly in many countries around the world. Additionally,
disease [36]. RR is another critical factor implicated in five out of there are signs indicating that COVID-19 will become endemic
the six decision-making outcomes, indicating an important role in with time but not eradicated. Despite the reduction in the spread
determining the status of the patients [37]. of the virus, the identified effective factors may facilitate better
Several studies have been conducted regarding COVID-19 management of COVID-19, especially in the upcoming endemic
and the effective risk factors in clinical decision-making. Most phase, as well as in future pandemics.
DOI: https://doi.org/10.36922/jctr.22.00226