Evidence map›Paper›PMID 16423119›Full record

Trial reportJournal of general internal medicine2006

Randomized controlled trial of an informatics-based intervention to increase statin prescription for secondary prevention of coronary disease.

William T Lester, Richard W Grant, G Octo Barnett, Henry C Chueh

2 registry-linked trialsOpen access · bronzeAbstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Journal of general internal medicine, 2006. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 2 registered trials, which are not on this map. Cited by 39 papers, 15 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
39citing papers in PubMed, 15 pooled it
3.0field-weighted citation impact, top 10% 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.

NCT03584048 completednot on this mapstarted 2018, after this paper: background citation

Charlotte Retention in Care Study - Clinical Decision Support System Prompts

Typeobservational_patient_registrySponsorEpividianRan2018 to 2019Enrolled6,500ConditionsHIV I InfectionArmsAlert to provider
NCT04147832 completednot on this mapstarted 2020, after this paper: background citation

Epividian, Inc. and AIDS Healthcare Foundation: Positive Pathways - HIV Retention in Care RIC-20190212 (Pro00037143)

TypeobservationalSponsorEpividianRan2020 to 2021Enrolled10,521ConditionsHIV/AIDSArmsAlert to provider
3 · Its place in the literature

Who cites it

39 citing papers in PubMed, 15 syntheses or guidelines pooled it, 69 citations in OpenAlex.

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  5. Email for clinical communication between healthcare professionals.The Cochrane database of systematic reviews · 2015
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  7. Computerized advice on drug dosage to improve prescribing practice.The Cochrane database of systematic reviews · 2013
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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

4 authors at 1 institution in 1 country.

William T LesterLaboratory of Computer Science, Massachusetts General Hospital, and Harvard Medical School, Boston, Mass, USA. wlester@partners.org
Richard W Grant
G Octo Barnett
Henry C Chueh
Harvard University · US

Funding

Overcoming Barriers to Evidence-Based Diabetes CareK23DK067452 · NIDDK · MASSACHUSETTS GENERAL HOSPITAL · PI GRANT, RICHARD W · 2005 to 2009
$653k
NIDDK NIH HHS K23 DK067452
6 · The paper itself

Abstract

objectiveSuboptimal treatment of hyperlipidemia in patients with coronary artery disease (CAD) is well documented. We report the impact of a computer-assisted physician-directed intervention to improve secondary prevention of hyperlipidemia. DESIGN AND

settingTwo hundred thirty-five patients under the care of 14 primary care physicians in an academically affiliated practice with an electronic health record were enrolled in this proof-of-concept physician-blinded randomized, controlled trial. Each patient with CAD or risk equivalent above National Cholesterol Education Program-recommended low-density lipoprotein (LDL) treatment goal for greater than 6 months was randomized, stratified by physician and baseline LDL. Physicians received a single e-mail per intervention patient. E-mails were visit independent, provided decision support, and facilitated "one-click" order writing. MEASUREMENTS: The primary outcomes were changes in hyperlipidemia prescriptions, time to prescription change, and changes in LDL levels. The time spent using the system was assessed among intervention patients.

resultsA greater proportion of intervention patients had prescription changes at 1 month (15.3% vs 2%, P=.001) and 1 year (24.6% vs 17.1%, P=.14). The median interval to first medication adjustment occurred earlier among intervention patients (0 vs 7.1 months, P=.005). Among patients with baseline LDLs >130 mg/dL, the first postintervention LDLs were substantially lower in the intervention group (119.0 vs 138.0 mg/dL, P=.04). Physician processing time was under 60 seconds per e-mail.

conclusionA visit-independent disease management tool resulted in significant improvement in secondary prevention of hyperlipidemia at 1-month postintervention and showed a trend toward improvement at 1 year.

Indexed as

Electronic MailMedical Order Entry SystemsReminder SystemsAdultCoronary DiseaseDecision Support Systems, ClinicalDisease ManagementDrug PrescriptionsFemaleHospitals, UniversityHumansHydroxymethylglutaryl-CoA Reductase InhibitorsHyperlipidemiasMaleMedical Records Systems, ComputerizedMiddle AgedHydroxymethylglutaryl-CoA Reductase Inhibitors

Identifiers

PMID16423119
PMCPMC1484624
OpenAlexW1985899508

What OpenQuestion holds

Texttitle and abstract
Read underepoch 390

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.