Evidence map›Paper›PMID 20212028›Full record

SynthesisCMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne2010

Effect of point-of-care computer reminders on physician behaviour: a systematic review.

Kaveh G Shojania, Alison Jennings, Alain Mayhew, Craig Ramsay, Martin Eccles, Jeremy Grimshaw

Abstract readSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne, 2010. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 109 papers, 21 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
109citing papers in PubMed, 21 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

109 citing papers in PubMed, 21 syntheses or guidelines pooled it.

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  11. A systematic review of the implementation and impact of asthma protocols.BMC medical informatics and decision making · 2014
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  15. Methods for improving the quality of palliative care delivery: a systematic review.The American journal of hospice & palliative care · 2014
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49 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

6 authors.

Kaveh G ShojaniaDepartment of Medicine, Sunnybrook Health Sciences Centre and University of Toronto Centre for Patient Safety, Toronto, Ont. kaveh.shojania@utoronto.ca
Alison Jennings
Alain Mayhew
Craig Ramsay
Martin Eccles
Jeremy Grimshaw

Funding

Chief Scientist Office HSRU2CIHR
6 · The paper itself

Abstract

backgroundThe opportunity to improve care using computer reminders is one of the main incentives for implementing sophisticated clinical information systems. We conducted a systematic review to quantify the expected magnitude of improvements in processes of care from computer reminders delivered to clinicians during their routine activities.

methodsWe searched the MEDLINE, Embase and CINAHL databases (to July 2008) and scanned the bibliographies of retrieved articles. We included studies in our review if they used a randomized or quasi-randomized design to evaluate improvements in processes or outcomes of care from computer reminders delivered to physicians during routine electronic ordering or charting activities.

resultsAmong the 28 trials (reporting 32 comparisons) included in our study, we found that computer reminders improved adherence to processes of care by a median of 4.2% (interquartile range [IQR] 0.8%-18.8%). Using the best outcome from each study, we found that the median improvement was 5.6% (IQR 2.0%-19.2%). A minority of studies reported larger effects; however, no study characteristic or reminder feature significantly predicted the magnitude of effect except in one institution, where a well-developed, "homegrown" clinical information system achieved larger improvements than in all other studies (median 16.8% [IQR 8.7%-26.0%] v. 3.0% [IQR 0.5%-11.5%]; p = 0.04). A trend toward larger improvements was seen for reminders that required users to enter a response (median 12.9% [IQR 2.7%-22.8%] v. 2.7% [IQR 0.6%-5.6%]; p = 0.09).

interpretationComputer reminders produced much smaller improvements than those generally expected from the implementation of computerized order entry and electronic medical record systems. Further research is required to identify features of reminder systems consistently associated with clinically worthwhile improvements.

Indexed as

Point-of-Care SystemsPractice Patterns, Physicians'Reminder SystemsHumansOutcome Assessment, Health CareQuality Assurance, Health CareRandomized Controlled Trials as Topic

Identifiers

PMID20212028
PMCPMC2842864

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.