Translational computerized clinical decision support systems for Alzheimer's disease: A systematic review

Background Alzheimer's disease (AD), marked by progressive memory loss and cognitive decline, poses diagnostic challenges due to its multifactorial nature. Therefore, researchers are increasingly leveraging artificial intelligence and data-driven approaches to develop computerized clinical decision support systems (CCDSS), aiming to enhance early detection, improve treatment, and slow disease progression. Objective This study seeks to conduct a systematic review of the most recently developed AD-CCDSS, delving into their progress and the challenges to guide future development and implementation of CCDSS for AD-related decision-making and intervention strategies. Methods We follow the PRISMA 2020 guideline to search for articles published within the past seven years across PubMed, ScienceDirect, IEEE Xplore Digital Library, Web of Science, and Scopus, with Google Scholar as a supplementary source. Key components are then extracted from the selected studies for qualitative analysis, including data modalities, computational modeling approaches, system explainability and interpretability, research priorities, and graphical user interfaces designed for non-technical stakeholders. Results After searching and removing duplicates, we meticulously selected 55 studies. After reviewing key components of CCDSS, we highlight advancements and potential clinical applications, demonstrating their promise in enhancing decision support. However, despite growing attention to explainability in AD-CCDSS, its clinical applicability remains limited. Moreover, challenges such as multi-center system interoperability and data security remain underexplored, hindering real-world implementation. Conclusions This study analyzes recent translational AD-CCDSS, identifying key challenges in advancing CCDSS for clinical applications. It offers insights for researchers to enhance CCDSS development and facilitate their integration into clinical practice.