SynthesisBMJ (Clinical research ed.)2005
Improving clinical practice using clinical decision support systems: a systematic review of trials to identify features critical to success.
Synthesis in BMJ (Clinical research ed.), 2005. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 3 registered trials, which are not on this map. Cited by 1,026 papers, 13 of them syntheses that pooled 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.
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.
Implementation of an Electronic Clinical Decision Support System (eCDSS) for the Early Recognition and Management of Diabetes and Dysglycaemia in Secondary Mental Healthcare : Feasibility Study
Using Personalized Risk and Digital Tools to Guide Transitions Following Acute Kidney Events - Virtual Care: Virtual Home Hospital With Remote Monitoring to Reduce Acute Care Hospitalization
Implementing Best Practice Advisories to Reduce Inequities in Technology Use for People With Type 1 Diabetes
Who cites it
1,026 citing papers in PubMed, 13 syntheses or guidelines pooled it.
- Digital patient safety interventions in primary care: a systematic review and meta-analysis.BMC medicine · 2026Pooled it
- Alert fatigue measurement in clinical decision support: a systematic review.Journal of the American Medical Informatics Association : JAMIA · 2026Pooled it
- Effectiveness of quality improvement interventions in improving cardiovascular disease-related outcomes in primary and tertiary care: A systematic review and meta-analyses.BMC primary care · 2025Pooled it
- Improving Explainability and Integrability of Medical AI to Promote Health Care Professional Acceptance and Use: Mixed Systematic Review.Journal of medical Internet research · 2025Pooled it
- Facilitators and Barriers of the Use of Prognostic Models for Clinical Decision Making in Acute Neurologic Care: A Systematic Review.Medical decision making : an international journal of the Society for Medical Decision Making · 2025Pooled it
- The implementation challenge of computerised clinical decision support systems for the detection of disease in primary care: systematic review and recommendations.Implementation science : IS · 2025Pooled it
- Digital tracking, provider decision support systems, and targeted client communication via mobile devices to improve primary health care.The Cochrane database of systematic reviews · 2025Pooled it
- The mHealth clinical decision-making tools for maternal and perinatal health care in Sub-Saharan Africa: A systematic review.PloS one · 2025Pooled it
- Health Care Professionals' Experience of Using AI: Systematic Review With Narrative Synthesis.Journal of medical Internet research · 2024Pooled it
- How intervention studies measure the effectiveness of medication safety-related clinical decision support systems in primary and long-term care: a systematic review.BMC medical informatics and decision making · 2024Pooled it
- The role of information systems in emergency department decision-making-a literature review.Journal of the American Medical Informatics Association : JAMIA · 2024Pooled it
- Genetically guided precision medicine clinical decision support tools: a systematic review.Journal of the American Medical Informatics Association : JAMIA · 2024Pooled it
- Characteristics and impact of interventions to support healthcare providers' compliance with guideline recommendations for breast cancer: a systematic literature review.Implementation science : IS · 2023Pooled it
- Generative AI-enabled clinical decision support system in primary care: a pragmatic, cluster-randomized trial.Nature medicine · 2026Trial
- Community health worker-led versus facility-based type 2 diabetes care in rural Lesotho: a cluster-randomized trial within the ComBaCaL cohort study.BMC medicine · 2026 · on this mapTrial
- Lay community health worker-led care with mobile decision support for uncontrolled hypertension: a cluster-randomized trial.Nature medicine · 2026Trial
- Trial
- AI-Assisted Cardiovascular Risk Assessment by General Practitioners in Resource-Constrained Indonesian Settings Using a Conceptual Prototype: Randomized Controlled Study.Journal of medical Internet research · 2025Trial
- Artificial Intelligence-Enabled ECGs for Atrial Fibrillation Identification and Enhanced Oral Anticoagulant Adoption: A Pragmatic Randomized Clinical Trial.Journal of the American Heart Association · 2025Trial
- Effect of a clinical decision support system for non-valvular atrial fibrillation on improving appropriate anticoagulation treatment in China's primary care: a cluster randomized controlled trial.BMC primary care · 2025Trial
966 more citing papers are in PubMed but not listed here.
Corrections and comments
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Authors and funding
4 authors.
Funding
Abstract
objectiveTo identify features of clinical decision support systems critical for improving clinical practice.
designSystematic review of randomised controlled trials. DATA SOURCES: Literature searches via Medline, CINAHL, and the Cochrane Controlled Trials Register up to 2003; and searches of reference lists of included studies and relevant reviews. STUDY SELECTION: Studies had to evaluate the ability of decision support systems to improve clinical practice. DATA EXTRACTION: Studies were assessed for statistically and clinically significant improvement in clinical practice and for the presence of 15 decision support system features whose importance had been repeatedly suggested in the literature.
resultsSeventy studies were included. Decision support systems significantly improved clinical practice in 68% of trials. Univariate analyses revealed that, for five of the system features, interventions possessing the feature were significantly more likely to improve clinical practice than interventions lacking the feature. Multiple logistic regression analysis identified four features as independent predictors of improved clinical practice: automatic provision of decision support as part of clinician workflow (P < 0.00001), provision of recommendations rather than just assessments (P = 0.0187), provision of decision support at the time and location of decision making (P = 0.0263), and computer based decision support (P = 0.0294). Of 32 systems possessing all four features, 30 (94%) significantly improved clinical practice. Furthermore, direct experimental justification was found for providing periodic performance feedback, sharing recommendations with patients, and requesting documentation of reasons for not following recommendations.
conclusionsSeveral features were closely correlated with decision support systems' ability to improve patient care significantly. Clinicians and other stakeholders should implement clinical decision support systems that incorporate these features whenever feasible and appropriate.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
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.