Evidence map›Paper›PMID 15762903›Full record

Trial reportHealth services research2005

Can computer-generated evidence-based care suggestions enhance evidence-based management of asthma and chronic obstructive pulmonary disease? A randomized, controlled trial.

William M Tierney, J Marc Overhage, Michael D Murray, Lisa E Harris, Xiao-Hua Zhou, George J Eckert, Faye E Smith, Nancy Nienaber, Clement J McDonald, Fredric D Wolinsky

Open access · greenAbstract readClinical TrialRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Health services research, 2005. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 62 papers, 33 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
62citing papers in PubMed, 33 pooled it
5.5field-weighted citation impact, top 3% of its field
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

62 citing papers in PubMed, 33 syntheses or guidelines pooled it, 124 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. Pooled it
  4. Pooled it
  5. Pooled it
  6. Pooled it
  7. Pharmacist services for non-hospitalised patients.The Cochrane database of systematic reviews · 2018
    Pooled it
  8. Pooled it
  9. Effects of health information technology on patient outcomes: a systematic review.Journal of the American Medical Informatics Association : JAMIA · 2016
    Pooled it
  10. Pooled it
  11. Pooled it
  12. A systematic review of the implementation and impact of asthma protocols.BMC medical informatics and decision making · 2014
    Pooled it
  13. Pooled it
  14. Computer decision support systems for asthma: a systematic review.NPJ primary care respiratory medicine · 2014
    Pooled it
  15. Pooled it
  16. Computerized advice on drug dosage to improve prescribing practice.The Cochrane database of systematic reviews · 2013
    Pooled it
  17. Pooled it
  18. Pooled it
  19. Pooled it
  20. Pooled it

2 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

10 authors at 1 institution in 1 country.

William M TierneyDepartment of Medicine, Indiana University School of Medicine, M200-OPW, Wishard Memorial Hospital, 1001 West 10th St., Indianapolis, IN 46202, USA.
J Marc Overhage
Michael D Murray
Lisa E Harris
Xiao-Hua Zhou
George J Eckert
Faye E Smith
Nancy Nienaber
Clement J McDonald
Fredric D Wolinsky
Sidney & Lois Eskenazi Hospital · US

Funding

COMPUTER-BASED PROSPECTIVE DRUG UTILIZATION REVIEWR01HS007763 · AHRQ · INDIANA UNIV-PURDUE UNIV AT INDIANAPOLIS · PI TIERNEY, WILLIAM M · 1993 to 1996
–
AHRQ HHS HS07763
6 · The paper itself

Abstract

objectiveTranslation of evidence-based guidelines into clinical practice has been inconsistent. We performed a randomized, controlled trial of guideline-based care suggestions delivered to physicians when writing orders on computer workstations. STUDY

settingInner-city academic general internal medicine practice. STUDY

designRandomized, controlled trial of 246 physicians (25 percent faculty general internists, 75 percent internal medicine residents) and 20 outpatient pharmacists. We enrolled 706 of their primary care patients with asthma or chronic obstructive pulmonary disease. Care suggestions concerning drugs and monitoring were delivered to a random half of the physicians and pharmacists when writing orders or filling prescriptions using computer workstations. A 2 x 2 factorial randomization of practice sessions and pharmacists resulted in four groups of patients: physician intervention, pharmacist intervention, both interventions, and controls. DATA EXTRACTION/COLLECTION

methodsAdherence to the guidelines and clinical activity was assessed using patients' electronic medical records. Health-related quality of life, medication adherence, and satisfaction with care were assessed using telephone questionnaires. PRINCIPAL

findingsDuring their year in the study, patients made an average of five scheduled primary care visits. There were no differences between groups in adherence to the care suggestions, generic or condition-specific quality of life, satisfaction with physicians or pharmacists, medication compliance, emergency department visits, or hospitalizations. Physicians receiving the intervention had significantly higher total health care costs. Physician attitudes toward guidelines were mixed.

conclusionsCare suggestions shown to physicians and pharmacists on computer workstations had no effect on the delivery or outcomes of care for patients with reactive airways disease.

Indexed as

Clinical Pharmacy Information SystemsDecision Support Systems, ClinicalAcademic Medical CentersAdultAgedAsthmaDrug Therapy, Computer-AssistedEvidence-Based MedicineFemaleGuideline AdherenceHumansInternal MedicineMaleMiddle AgedOutcome Assessment, Health CarePatient Satisfaction

Identifiers

PMID15762903
PMCPMC1361152
OpenAlexW2109710478

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.