Effects of computer-based clinical decision support systems on clinician performance and patient outcome. A critical appraisal of research.

Objective: To review the evidence from controlled trials of the effects of computer-based clinical decision support systems (CDSSs) on clinician performance and patient outcomes.Data Sources: The literature in the MEDLARS, EMBASE, SCISEARCH, and INSPEC databases was searched from 1974 to the present...

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Publicado en:Annals of Internal Medicine Vol. 120; no. 2; pp. 135 - 143
Autores principales: Johnston, Mary E., Langton, Karl B., Haynes, R. Brian, Mathieu, Alix, Johnston, M E, Langton, K B, Haynes, R B, Mathieu, A
Formato: meta analysis research Journal Article
Publicado: American College of Physicians 1/15/94
Acceso en línea:Ver este registro en EBSCOhost
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      dt: 1/15/94
      vid: 120
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      pub: American College of Physicians
      place: Philadelphia, Pennsylvania
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        10.7326/0003-4819-120-2-199401150-00007
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        6986983
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        atl: Effects of computer-based clinical decision support systems on clinician performance and patient outcome. A critical appraisal of research.
      aug:
        au:
          Johnston, Mary E.
          Langton, Karl B.
          Haynes, R. Brian
          Mathieu, Alix
          Johnston, M E
          Langton, K B
          Haynes, R B
          Mathieu, A
        affil: McMaster University, Hamilton, Ontario, Canada
      sug:
        subj:
          Clinical Competence Standards
          Decision Making, Computer Assisted
          Outcome Assessment Standards
          Human
          Quality Assurance
          Drug Therapy, Computer Assisted
          Diagnosis, Computer Assisted
          Reminder Systems
          Meta Analysis
          Validation Studies
          Comparative Studies
          Evaluation Research
          Multicenter Studies
          Scales
      ab: Objective: To review the evidence from controlled trials of the effects of computer-based clinical decision support systems (CDSSs) on clinician performance and patient outcomes.Data Sources: The literature in the MEDLARS, EMBASE, SCISEARCH, and INSPEC databases was searched from 1974 to the present. Conference proceedings and reference lists of relevant articles were reviewed. Evaluators of CDSSs were asked to identify additional studies.Study Selection: 793 citations were examined, and 28 controlled trials that met predefined criteria were reviewed in detail.Data Extraction: Study quality was assessed, and data on setting, clinicians and patients, method of allocation, computer system, and outcomes were abstracted and verified using a structured form. Separate summaries were prepared for physician and patient outcomes. Within each of these categories, studies were classified further according to the primary purpose of the CDSS: drug dose determination, diagnosis, or quality assurance.Results: Three of 4 studies of computer-assisted dosing, 1 of 5 studies of computer-aided diagnosis, 4 of 6 studies of preventive care reminder systems, and 7 of 9 studies of computer-aided quality assurance for active medical care that assessed clinician performance showed improvements in clinician performance using a CDSS. Three of 10 studies that assessed patient outcomes reported significant improvements.Conclusions: Strong evidence suggests that some CDSSs can improve physician performance. Additional well-designed studies are needed to assess their effects and cost-effectiveness, especially on patient outcomes.
      pubtype: Academic Journal
      doctype:
        meta analysis
        research
        Journal Article
      ougenre: Article
    language: English
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