Impact of the rounding-off function of the computerized physician order entry system on dose variations of chemotherapeutic drugs.

e17600 Background: EGMAIN-GX (Fujitsu Ltd., Tokyo, Japan) is a popular computerized physician order entry (CPOE) system in Japan. Version 2 was used since 2009, but the newly introduced version 4 has been used since 2012. Notable among the new features is the automatic rounding-off of the calculated dose of anticancer drugs to the nearest whole number. We conducted a study to examine the effect of the rounding-off function on dose variations with CPOE version 4 compared to version 2. Methods: Twelve physicians ordered 5 predefined chemotherapeutic regimens for a hypothetical patient: idarubicin and cytarabine; fludarabine and busulfan; rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone; cyclophosphamide, doxorubicin, vincristine, and dexamethasone; and rituximab, etoposide, cytarabine, cisplatin, and methylprednisolone. Data were entered twice for each regimen, using versions 2 and 4, and 1392 drugs were prescribed. We calculated the ratio of actual to ideal doses of chemotherapeutic dr...