Effect of a clinical evidence technology on patient skin disease outcomes in primary care: a clusterrandomized controlled trial.
Objective: Providers' use of clinical evidence technologies (CETs) improves their diagnosis and treatment decisions. Despite these benefits, few studies have evaluated the impact of CETs on patient outcomes. The investigators evaluated the effect of one CET, VisualDx, on skin problem outcomes in pri...
| Publicado en: | Journal of the Medical Library Association Vol. 107; no. 2; pp. 151 - 163 |
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| Autores principales: | , |
| Formato: | research tables/charts randomized controlled trial Journal Article |
| Publicado: |
University of Pittsburgh, University Library System
Apr2019
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=135961079&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 135961079 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 15365050 PI8 jtl: Journal of the Medical Library Association issn: 15365050 maglogo: N pubinfo: dt: Apr2019 vid: 107 iid: 2 pid: 60406 pub: University of Pittsburgh, University Library System place: Pittsburgh, Pennsylvania artinfo: ui: 135961079 135961079 135961079 10.5195/jmla.2019.581 135961079 ppf: 151 ppct: 12 formats: fmt: @attributes: type: P tig: atl: Effect of a clinical evidence technology on patient skin disease outcomes in primary care: a clusterrandomized controlled trial. aug: au: Burke, Marianne Littenberg, Benjamin affil: Medical Library, University of Vermont, Burlington, VT 05405 sug: subj: Skin Diseases Therapy Technology, Medical Primary Health Care Outcomes (Health Care) Human Randomized Controlled Trials Random Assignment Medical Practice, Evidence-Based Cluster Analysis Ambulatory Care Facilities United States Cox Proportional Hazards Model Wilcoxon Rank Sum Test Logistic Regression Confidence Intervals Odds Ratio Electronic Health Records Interviews Data Analysis Software ab: Objective: Providers' use of clinical evidence technologies (CETs) improves their diagnosis and treatment decisions. Despite these benefits, few studies have evaluated the impact of CETs on patient outcomes. The investigators evaluated the effect of one CET, VisualDx, on skin problem outcomes in primary care. Methods: A cluster-randomized controlled pragmatic trial was conducted in outpatient clinics at an academic medical center in the northeastern United States. Participants were primary care providers (PCPs) and their adult patients seen for skin problems. The intervention was VisualDx, as used by PCPs. Outcomes were patient-reported time from index clinic visit to problem resolution, and the number of follow-up visits to any provider for the same problem. PCPs who were randomly assigned to the intervention agreed to use VisualDx as their primary evidence source for skin problems. Control group PCPs agreed not to use VisualDx. Investigators collected outcome data from patients by phone at thirty-day intervals. Cox proportional hazards models assessed time to resolution. Wilcoxon-rank sum tests and logistic regression compared the need for return appointments. Results: Thirty-two PCPs and 433 patients participated. In proportional hazards modelling adjusted for provider clusters, the time from index visit to skin problem resolution was similar in both groups (hazard ratio=0.92; 95% confidence interval [CI]=0.70, 1.21; p=0.54). Patient follow-up appointments did not differ significantly between groups (odds ratio=1.26; CI=0.94, 1.70; p=0.29). Conclusion: This pragmatic trial tested the effectiveness of VisualDx on patient-reported skin disease outcomes in a generalizable clinical setting. There was no difference in skin problem resolution or number of follow-up visits when PCPs used VisualDx. pubtype: Academic Journal doctype: research tables/charts randomized controlled trial Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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