Effects of computerized clinical decision support systems on practitioner performance and patient outcomes: Methods of a decision-maker-researcher partnership systematic review
By R. B. Haynes, N. Wilczynski, the Computerized Clinical Decision Support System Syst Team. 2010
257 citations recorded by the source corpus.
BackgroundComputerized clinical decision support systems are information technology-based systems designed to improve clinical decision-making. As with any healthcare intervention with claims to improve process of care or patient outcomes, decision support systems should be rigorously evaluated before widespread dissemination into clinical practice. Engaging healthcare providers and managers in the review process may facilitate knowledge translation and uptake. The objective of this research was to form a partnership of healthcare providers, managers, and researchers to review randomized controlled trials assessing the effects of computerized decision support for six clinical application areas: primary preventive care, therapeutic drug monitoring and dosing, drug prescribing, chronic disease management, diagnostic test ordering and interpretation, and acute care management; and to identify study characteristics that predict benefit.MethodsThe review was undertaken by the Health Information Research Unit, McMaster University, in partnership with Hamilton Health Sciences, the Hamilton, Niagara, Haldimand, and Brant Local Health Integration Network, and pertinent healthcare service teams. Following agreement on information needs and interests with decision-makers, our earlier systematic review was updated by searching Medline, EMBASE, EBM Review databases, and Inspec, and reviewing reference lists through 6 January 2010. Data extraction items were expanded according to input from decision-makers. Authors of primary studies were contacted to confirm data and to provide additional information. Eligible trials were organized according to clinical area of application. We included randomized controlled trials that evaluated the effect on practitioner performance or patient outcomes of patient care provided with a computerized clinical decision support system compared with patient care without such a system.ResultsData will be summarized using descriptive summary measures, including proportions for categorical variables and means for continuous variables. Univariable and multivariable logistic regression models will be used to investigate associations between outcomes of interest and study specific covariates. When reporting results from individual studies, we will cite the measures of association and p-values reported in the studies. If appropriate for groups of studies with similar features, we will conduct meta-analyses.ConclusionA decision-maker-researcher partnership provides a model for systematic reviews that may foster knowledge translation and uptake.
Subfields: General Health Professions, Health Information Management, Statistics and Probability
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Citations in the corpus
- Ergonomics Society of the Human Factors and Human Factors: The Journal (2014, unknown): “The apparent failure to use many Stage 3 automation diagnostic aids by health care practitioners (Garg et al., 2005) appears to result in part from an alert rate that”
- Humans: Still Vital After All These Years of Automation (2008, background): “The apparent failure to use many Stage 3 automation diagnostic aids by health care practitioners (Garg et al., 2005) appears to result in part from an alert rate that does not fully account for contextual factors (Patterson, Nguyen, Halloran, & Asch, 2004).”
- Situation Awareness, Mental Workload, and Trust in Automation: Viable, Empirically Supported Cognitive Engineering Constructs (2008, background): “Very different decision aids should be provided to physicians if their SA is poor (diagnostic assistance) than if the treatment they prescribe (decision and choice) is wanting (Garg et al., 2005; Morrow, Wickens, & North, 2006).”
- Effectiveness of computerized decision support systems linked to electronic health records: a systematic review and meta-analysis. (2014, methodology): “We adapted the definition of a CDSS by Haynes et al.(20) and Eberhardt et al.”