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Decision support systems to improve health-related quality of life in hemodialysis patients. There is a need to demonstrate the effectiveness of outcomes and cost-utility studies for health care policy makers, and this needs information on the adoption, implementation, and evaluation of outcome and economic decision support systems for health services, particularly for chronic disease management programs. The development and evaluation of an outcome-driven decision support system to assist health care professionals in managing hemodialysis patients. The E-Tutor System, a decision support tool developed by the present authors in cooperation with an experienced dialysis unit, enables health care professionals to manage a hemodialysis patient in a standard fashion. A randomized controlled trial was undertaken to evaluate the effect of using the E-Tutor System on the quality of life (QOL) of hemodialysis patients. The E-Tutor System was incorporated into the hemodialysis unit over a four-month period. During the comparison phase, the experience of the patients and the doctors and nurses were recorded at baseline, at the mid-point of the study, and at the conclusion of the study. QOL was assessed by standard QOL measures. Measures were the short form of the Medical Outcomes Study Short Form (SF-36), Health Utilities Index 3, and Self-Efficacy Questionnaire. Interrogation of the records of the participating patients showed that the E-Tutor System was used by the majority of the patients. The analysis of their experience showed a high degree of satisfaction with the E-Tutor system. The comparison of the QOL scores of the E-Tutor and control groups showed no differences at baseline. At the mid-point of the study, the QOL of the E-Tutor group showed a statistically significant improvement compared with the control group. At the end of the study, the QOL of the E-Tutor group showed a further statistically significant improvement compared with the control group. The results suggest that the use of the E-Tutor System has a positive effect on the QOL of hemodialysis patients and that decision-support systems play an important role in improving patient care and health outcomes.

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