Trial reportJournal of the American Medical Informatics Association : JAMIA
Improving ambulatory prescribing safety with a handheld decision support system: a randomized controlled trial.
Trial report in Journal of the American Medical Informatics Association : JAMIA. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 24 papers, 11 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.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
24 citing papers in PubMed, 11 syntheses or guidelines pooled it, 96 citations in OpenAlex.
- How does the Content and Dissemination of Communications on the Risks of Medicines Affect Prescriber Awareness, Knowledge, and Behaviour: A Systematic Review.Drug safety · 2026Pooled it
- Potentiality of algorithms and artificial intelligence adoption to improve medication management in primary care: a systematic review.BMJ open · 2023Pooled it
- Decision-support tools via mobile devices to improve quality of care in primary healthcare settings.The Cochrane database of systematic reviews · 2021Pooled it
- Strengthening Delivery of Health Services Using Digital Devices.Global health, science and practice · 2018Pooled it
- Use of handheld computers in clinical practice: a systematic review.BMC medical informatics and decision making · 2014Pooled it
- Risks to patient safety associated with implementation of electronic applications for medication management in ambulatory care--a systematic review.BMC medical informatics and decision making · 2013Pooled it
- STARE-HI - Statement on Reporting of Evaluation Studies in Health Informatics: explanation and elaboration.Applied clinical informatics · 2013Guideline
- The effectiveness of mobile-health technologies to improve health care service delivery processes: a systematic review and meta-analysis.PLoS medicine · 2013Pooled it
- Features predicting the success of computerized decision support for prescribing: a systematic review of randomized controlled trials.BMC medical informatics and decision making · 2009Pooled it
- The impact of mobile handheld technology on hospital physicians' work practices and patient care: a systematic review.Journal of the American Medical Informatics Association : JAMIAPooled it
- The effectiveness of integrated health information technologies across the phases of medication management: a systematic review of randomized controlled trials.Journal of the American Medical Informatics Association : JAMIAPooled it
- Randomized controlled trial demonstrates novel tools to assess patient outcomes of Indigenous cultural safety training.BMC medicine · 2024Trial
- Investigating the fluid and electrolyte prescribing knowledge of Foundation Year doctors.Annals of the Royal College of Surgeons of England · 2026Article
- Celebrating Eta Berner and her influence on biomedical and health informatics.Journal of the American Medical Informatics Association : JAMIA · 2024Article
- A Bridging Opportunities Work-frame to develop mobile applications for clinical decision making.Future science OA · 2015Article
- Unannounced standardized patients: a promising method of assessing patient-centered care in your health care system.BMC health services research · 2014Article
- General practitioners' attitudes and preparedness towards Clinical Decision Support in e-Prescribing (CDS-eP) adoption in the West of Ireland: a cross sectional study.BMC medical informatics and decision making · 2010Article
- Evaluating eHealth: how to make evaluation more methodologically robust.PLoS medicine · 2009Article
- [Scientific basis for using personal digital assistants (PDA) in medical practice].Atencion primaria · 2009Article
- The use of the Personal Digital Assistant (PDA) among personnel and students in health care: a review.Journal of medical Internet research · 2008Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
11 authors at 2 institutions in 1 country.
Funding
Abstract
objectiveTo evaluate the effectiveness of a personal digital assistant (PDA)-based clinical decision support system (CDSS) on nonsteroidal anti-inflammatory drug (NSAID) prescribing safety in the outpatient setting.
designThe design was a randomized, controlled trial conducted in a university-based resident clinic. Internal medicine residents received a PDA-based CDSS suite. For intervention residents, the CDSS included a prediction rule for NSAID-related gastrointestinal risk assessment and treatment recommendations. Unannounced standardized patients (SPs) trained to portray musculoskeletal symptoms presented to study physicians. Safety outcomes were assessed from the prescriptions given to the SPs. Each prescription was reviewed by a committee of clinicians blinded to participant, intervention group assignment, and baseline or follow-up status. MEASUREMENTS: Prescriptions were judged as safe or unsafe. The main outcome measure was the differential change in unsafe prescribing of NSAIDs for the intervention versus the control group.
resultsAt baseline, the mean proportion of cases per physician with unsafe prescriptions for the two groups was similar (0.27 vs. 0.29, p > 0.05). Controlling for baseline performance, intervention participants prescribed more safely than controls after receiving the CDSS (0.23 vs. 0.45 [F = 4.24, p < 0.05]). With the CDSS, intervention participants documented more complete assessment of patient gastrointestinal risk from NSAIDs.
conclusionPARTICIPANTS provided with a PDA-based CDSS for NSAID prescribing made fewer unsafe treatment decisions than participants without the CDSS.
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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.