Research Appraisals
Evidence-based critical appraisals of the latest medical research, systematically evaluated using Oxford CEBM methodology.
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Journal of the American Medical Informatics Association : JAMIA
Alert fatigue measurement in clinical decision support: a systematic review
BACKGROUND: Alert fatigue is defined as alert dismissals due to excessive or irrelevant alerts and is frequently cited as a barrier to clinical decision support system use and impact. However, the criteria for determining the presence or absence of alert fatigue are poorly defined. The objective of this systematic review of systematic reviews was to identify operationalized definitions and measures of alert fatigue or alert-related metrics. METHODS: Systematic reviews reporting at least one alert-related metric or measure/operationalization of alert fatigue for physician-directed electronic alerts were included. The Cochrane Library, Embase, and PubMed were searched from database start to 2024. The Revised Assessment of Multiple Systematic Reviews was used to assess study quality and risk of bias. Data were synthesized narratively and with descriptive statistics. RESULTS: A total of 22 studies were included in the review. Studies reported between 1 and 11 alert metrics. Studies were most often of medium quality. Reporting of primary study characteristics was frequently judged to be insufficient. Only one article reported an operational definition of alert fatigue. The most common alert metrics were quantity, override rate, and acceptance rate. DISCUSSION: Alert fatigue measurement methods are not clearly or consistently defined in systematic reviews related to alert fatigue in clinical decision support. Reporting of other primary study characteristics is often limited. We recommend that future efforts use a significant, sustained decrease in appropriate alert response rates from an established baseline as a measure of alert fatigue.
2 Aug 2026
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Anonymized but Useful Synthetic Tabular Health Data for AI based Fall Risk Assessment
Artificial Intelligence (AI) bears potential for improving health care, but this depends on the availability of open-access, realistic, and useful data. To facilitate AI model development in health care we release SynTabFall, a novel synthetic dataset for fall risk assessment. With a total of 745,380 samples and 44 attributes such as demographics, diseases, mobility and cognition related risk factors, this tabular dataset allows for training fall risk prediction models without access to the original patient data. Models trained on our synthetic dataset can reach predictive performance scores in fall risk assessment which are on par with models trained on real data. To support others in sharing data we also describe a process that was developed over multiple years in one of Germany's largest hospitals in close collaboration between data protection officers, health care staff, informaticians and AI engineers. The proposed data sharing approach combines established methods for anonymization and modern generative AI (genAI) methods for synthesizing tabular data and allows for sharing health care data responsibly without sacrificing its utility. We release the synthetic fall risk dataset along with the software developed for synthetic data generation and evaluation.
26 July 2026
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