Trial reportJournal of the American Medical Informatics Association : JAMIA
Randomized clinical trial of a customized electronic alert requiring an affirmative response compared to a control group receiving a commercial passive CPOE alert: NSAID--warfarin co-prescribing as a test case.
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 33 papers, 6 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
33 citing papers in PubMed, 6 syntheses or guidelines pooled it, 55 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
- The effect of clinical decision support systems on clinical outcomes in acute kidney injury: a systematic review and meta-analysis of randomized controlled trials.Renal failure · 2024Pooled it
- The effects of clinical decision support system for prescribing medication on patient outcomes and physician practice performance: a systematic review and meta-analysis.BMC medical informatics and decision making · 2021Pooled it
- Systematic review of interventions to improve safety and quality of anticoagulant prescribing for therapeutic indications for hospital inpatients.European journal of clinical pharmacology · 2019Pooled it
- Information Technology-Based Interventions to Improve Drug-Drug Interaction Outcomes: A Systematic Review on Features and Effects.Journal of medical systems · 2017Pooled it
- The effects of on-screen, point of care computer reminders on processes and outcomes of care.The Cochrane database of systematic reviews · 2009Pooled it
- Electronic Medical Alerts Increase Screening for Chronic Hepatitis B: A Randomized, Double-Blind, Controlled Trial.Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology · 2018Trial
- Automated, electronic alerts for acute kidney injury: a single-blind, parallel-group, randomised controlled trial.Lancet (London, England) · 2015Trial
- A trial of in-hospital, electronic alerts for acute kidney injury: design and rationale.Clinical trials (London, England) · 2014Trial
- Electronic alerts for triage protocol compliance among emergency department triage nurses: a randomized controlled trial.Nursing researchTrial
- Clinical Decision Support to Increase Naloxone Co-prescribing from the Inpatient Setting.Journal of general internal medicine · 2026Observational
- Effectiveness of computerised alerts to reduce drug-drug interactions (DDIs) and DDI-related harm in hospitalised patients: a quasi-experimental controlled pre-post study.BMJ quality & safety · 2025Article
- User-Centered Design and Evaluation of Clinical Decision Support to Improve Early Peanut Introduction: Formative Study.JMIR formative research · 2023Article
- Effectiveness of clinical decision support in controlling inappropriate red blood cell and platelet transfusions, speciality specific responses and behavioural change.BMC medical informatics and decision making · 2022Article
- Clinician collaboration to improve clinical decision support: the Clickbusters initiative.Journal of the American Medical Informatics Association : JAMIA · 2022Article
- Electronic health record alerts enhance mass screening for chronic hepatitis B.Scientific reports · 2020Article
- Interrupting providers with clinical decision support to improve care for heart failure.International journal of medical informatics · 2019Article
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- Interruptive Versus Noninterruptive Clinical Decision Support: Usability Study.JMIR human factors · 2019Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors at 2 institutions in 1 country.
Funding
Abstract
backgroundStudies that have looked at the effectiveness of computerized decision support systems to prevent drug-drug interactions have reported modest results because of low response by the providers to the automated alerts.
objectiveTo evaluate, within an inpatient computerized physician order entry (CPOE) system, the incremental effectiveness of an alert that required a response from the provider, intended as a stronger intervention to prevent concurrent orders of warfarin and non-steroidal anti-inflammatory drugs (NSAIDs).
designRandomized clinical trial of 1963 clinicians assigned to either an intervention group receiving a customized electronic alert requiring affirmative response or a control group receiving a commercially available passive alert as part of the CPOE. The study duration was 2 August 2006 to 15 December 2007. MEASUREMENTS: Alert adherence was compared between study groups.
resultsThe proportion of desired ordering responses (ie, not reordering the alert-triggering drug after firing) was lower in the intervention group (114/464 (25%) customized alerts issued) than in the control group (154/560 (28%) passive alerts firing). The adjusted OR of inappropriate ordering was 1.22 (95% CI 0.69 to 2.16).
conclusionA customized CPOE alert that required a provider response had no effect in reducing concomitant prescribing of NSAIDs and warfarin beyond that of the commercially available passive alert received by the control group. New CPOE alerts cannot be assumed to be effective in improving prescribing, and need evaluation.
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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.