Evidence map›Paper›PMID 10710578›Full record

Trial reportBMJ (Clinical research ed.)2000

Evaluation of computer based clinical decision support system and risk chart for management of hypertension in primary care: randomised controlled trial.

A A Montgomery, T Fahey, T J Peters, C MacIntosh, D J Sharp

Abstract readClinical TrialRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in BMJ (Clinical research ed.), 2000. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 91 papers, 26 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
91citing papers in PubMed, 26 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

91 citing papers in PubMed, 26 syntheses or guidelines pooled it.

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  4. Risk scoring for the primary prevention of cardiovascular disease.The Cochrane database of systematic reviews · 2017
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  13. Self-monitoring and other non-pharmacological interventions to improve the management of hypertension in primary care: a systematic review.The British journal of general practice : the journal of the Royal College of General Practitioners · 2010
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  20. A systematic review of information in decision aids.Health expectations : an international journal of public participation in health care and health policy · 2007
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31 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

  • Commented on by
5 · Who and what money

Authors and funding

5 authors.

A A MontgomeryDivision of Primary Health Care, University of Bristol, Bristol BS8 2PR.
T Fahey
T J Peters
C MacIntosh
D J Sharp

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectivesTo investigate the effect of a computer based clinical decision support system and a risk chart on absolute cardiovascular risk, blood pressure, and prescribing of cardiovascular drugs in hypertensive patients.

designCluster randomised controlled trial.

setting27 general practices in Avon.

participants614 patients aged between 60 and 79 years with high blood pressure.

interventionsPatients were randomised to computer based clinical decision support system plus cardiovascular risk chart; cardiovascular risk chart alone; or usual care.

main outcome measuresPercentage of patients in each group with a five year cardiovascular risk >/=10%, systolic blood pressure, diastolic blood pressure, prescribing of cardiovascular drugs.

resultsPatients in the computer based clinical decision support system and chart only groups were no more likely to have cardiovascular risk reduced to below 10% than patients receiving usual care. Patients in the computer based clinical decision support group were more likely to have a cardiovascular risk >/=10% than chart only patients, odds ratio 2.3 (95% confidence interval 1.1 to 4.8). The chart only group had significantly lower systolic blood pressure compared with the usual care group (difference in means -4.6 mm Hg (95% confidence interval -8.4 to -0.8)). Reduction of diastolic blood pressure did not differ between the three groups. The chart only group were twice as likely to be prescribed two classes of cardiovascular drugs and over three times as likely to be prescribed three or more classes of drugs compared with the other groups.

conclusionsThe computer based clinical decision support system did not confer any benefit in absolute risk reduction or blood pressure control and requires further development and evaluation before use in clinical care can be recommended. Use of chart guidelines are associated with a potentially important reduction in systolic blood pressure.

Indexed as

Decision Making, Computer-AssistedDecision Support Systems, ClinicalAgedAlgorithmsEvaluation Studies as TopicFemaleHumansHypertensionMaleMiddle AgedPractice Guidelines as TopicPrimary Health CareRisk Assessment

Identifiers

PMID10710578
PMCPMC27312

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.