Rule-Based CDS: A Literature Review of Impact and Evolution

This scoping review analyzed 28 studies published between 2007 and 2023 on the use of rule-based clinical decision support systems (CDSS) in medicine. Findings show that these systems effectively supported safer medication use, such as adverse drug event detection and insulin titration, while also reducing workload for complex lab interpretations. Technological implementations evolved from SQL and process rules to hybrid systems that combine natural language processing and machine learning, maintaining human-readable logic. Common challenges included interoperability, terminology mapping, and clinician adoption, but key pharmacy applications included medication safety surveillance, pharmacogenomic alerting, and dose adjustment.

Alnattah A, Jajroudi M, Fadafen SAN, et al. Artificial Intelligence in Clinical Decision-Making: A Scoping Review of Rule-Based Systems and Their Applications in Medicine. Cureus. 2025;17(8):e91333. Published 2025 Aug 31. doi:10.7759/cureus.91333