Evidence map›Paper›PMID 21422100›Full record

SynthesisJournal of the American Medical Informatics Association : JAMIA2011

Effects of clinical decision-support systems on practitioner performance and patient outcomes: a synthesis of high-quality systematic review findings.

Monique W M Jaspers, Marian Smeulers, Hester Vermeulen, Linda W Peute

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

Synthesis in Journal of the American Medical Informatics Association : JAMIA, 2011. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 236 papers, 24 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
236citing papers in PubMed, 24 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

236 citing papers in PubMed, 24 syntheses or guidelines pooled it.

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176 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

4 authors.

Monique W M JaspersDepartment of Medical Informatics, Academic Medical Center, Amsterdam, The Netherlands. m.w.jaspers@amc.uva.nl
Marian Smeulers
Hester Vermeulen
Linda W Peute

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveTo synthesize the literature on clinical decision-support systems' (CDSS) impact on healthcare practitioner performance and patient outcomes.

designLiterature search on Medline, Embase, Inspec, Cinahl, Cochrane/Dare and analysis of high-quality systematic reviews (SRs) on CDSS in hospital settings. Two-stage inclusion procedure: (1) selection of publications on predefined inclusion criteria; (2) independent methodological assessment of preincluded SRs by the 11-item measurement tool, AMSTAR. Inclusion of SRs with AMSTAR score 9 or above. SRs were thereafter rated on level of evidence. Each stage was performed by two independent reviewers.

results17 out of 35 preincluded SRs were of high methodological quality and further analyzed. Evidence that CDSS significantly impacted practitioner performance was found in 52 out of 91 unique studies of the 16 SRs examining this effect (57%). Only 25 out of 82 unique studies of the 16 SRs reported evidence that CDSS positively impacted patient outcomes (30%).

conclusionsFew studies have found any benefits on patient outcomes, though many of these have been too small in sample size or too short in time to reveal clinically important effects. There is significant evidence that CDSS can positively impact healthcare providers' performance with drug ordering and preventive care reminder systems as most clear examples. These outcomes may be explained by the fact that these types of CDSS require a minimum of patient data that are largely available before the advice is (to be) generated: at the time clinicians make the decisions.

Indexed as

Clinical CompetenceDecision Support Systems, ClinicalOutcome Assessment, Health CareElectronic PrescribingHumansMedical Order Entry SystemsReminder SystemsTherapy, Computer-Assisted

Identifiers

PMID21422100
PMCPMC3078663

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.