Evidence map›Paper›PMID 12574046›Full record

Trial reportBMJ (Clinical research ed.)2003

Practice based, longitudinal, qualitative interview study of computerised evidence based guidelines in primary care.

Nikki Rousseau, Elaine McColl, John Newton, Jeremy Grimshaw, Martin Eccles

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

Trial report in BMJ (Clinical research ed.), 2003. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 66 papers, 8 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
66citing papers in PubMed, 8 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

66 citing papers in PubMed, 8 syntheses or guidelines pooled it.

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  7. Computerized clinical decision support for prescribing: provision does not guarantee uptake.Journal of the American Medical Informatics Association : JAMIA
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6 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

5 authors.

Nikki RousseauCentre for Health Services Research, University of Newcastle upon Tyne, Newcastle upon Tyne NE2 4AA.
Elaine McColl
John Newton
Jeremy Grimshaw
Martin Eccles

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveTo understand the factors influencing the adoption of a computerised clinical decision support system for two chronic diseases in general practice.

designPractice based, longitudinal, qualitative interview study.

settingFive general practices in north east England.

participants13 respondents (two practice managers, three nurses, and eight general practitioners) gave a total of 19 semistructured interviews. 40 people in practices included in the randomised controlled trial (34 doctors, three nurses) and interview study (three doctors, one previously interviewed) gave feedback.

resultsNegative comments about the decision support system significantly outweighed the positive or neutral comments. Three main areas of concern among clinicians emerged: timing of the guideline trigger, ease of use of the system, and helpfulness of the content. Respondents did not feel that the system fitted well within the general practice context. Experience of "on-demand" information sources, which were generally more positively viewed, informed the comments about the system. Some general practitioners suggested that nurses might find the guideline content more clinically useful and might be more prepared to use a computerised decision support system, but lack of feedback from nurses who had experienced the system limited the ability to assess this.

conclusionsSignificant barriers exist to the use of complex clinical decision support systems for chronic disease by general practitioners. Key issues include the relevance and accuracy of messages and the flexibility to respond to other factors influencing decision making in primary care.

Indexed as

Attitude of Health PersonnelAttitude to ComputersDecision Making, Computer-AssistedChronic DiseaseDecision Support Systems, ClinicalEnglandFamily PracticeHumansInterviews as TopicLongitudinal StudiesPractice Guidelines as TopicQualitative Research

Identifiers

PMID12574046
PMCPMC143528

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

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.