Clinical evaluation of a computer-assisted decision support and documentation system for the primary care of polytrauma patients.

BACKGROUND

Polytrauma management demands rapid, high-stakes decisions under severe time pressure, increasing the risk of error and deviation from evidence-based protocols. Computer-assisted decision support systems (CDSS) may counter these risks by improving adherence to guidelines and reducing cognitive strain. We developed TraumaFlow, a CDSS integrating the German S3 guideline and ATLS® principles, and evaluated its impact in real-world trauma care.

METHODS

In a prospective study at a level 1 trauma center, 30 shock room cases were managed with TraumaFlow alongside the standard paper protocol and compared both with the corresponding paper documentation and with 30 conventionally documented cases from a historical cohort. System-generated recommendations were tracked for implementation. Usability was assessed by questionnaire, and workload measured with the NASA Raw Task Load Index (NASA-RTLX).

RESULTS

Eighteen residents (mean age 31 ± 4 years, 56% female) participated in 30 polytrauma cases. Documentation completeness was significantly higher with TraumaFlow compared to paper (20.5/25 items (82%) vs. 18.4/25 items (74%), p = 0.002). Of 74 clinical prompts, 37% triggered clinically relevant actions that might otherwise have been missed. Workload did not differ significantly between TraumaFlow-supported and conventional cases (35.0 ± 12.4 vs. 34.7 ± 15.3). Participants rated usability positively and reported improved confidence.

CONCLUSION

TraumaFlow enhanced documentation quality and supported guideline-based management in acute polytrauma care. Although no measurable reduction in workload was observed, the system improved structure, reduced risk of omission, and was well accepted by clinicians. These findings highlight the potential of CDSS to strengthen trauma team performance and standardize complex emergency care.

CLINICAL TRIAL REGISTRATION: https://drks.de/register/de/trial/DRKS00034201, Registration No. DRKS00034201.