ArticleJournal of the American Medical Informatics Association : JAMIA
Factors influencing alert acceptance: a novel approach for predicting the success of clinical decision support.
Article 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 59 papers, 1 of them a synthesis 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
59 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Comprehensive process model of clinical information interaction in primary care: results of a "best-fit" framework synthesis.Journal of the American Medical Informatics Association : JAMIA · 2018Pooled it
- Implementing prescriber-pharmacist collaboration to improve evidence-based medication prescribing using asynchronous, non-interruptive electronic health record notifications.Implementation science : IS · 2025Trial
- Trial
- Impact of electronic reminders on venous thromboprophylaxis after admissions and transfers.Journal of the American Medical Informatics Association : JAMIA · 2014Trial
- Making electronic prescribing alerts more effective: scenario-based experimental study in junior doctors.Journal of the American Medical Informatics Association : JAMIATrial
- Development and analysis of a SmPC-based machine-readable dataset of contraindications for clinical decision support and real-world data analysis.European journal of clinical pharmacology · 2026Article
- Article
- Integrating clinical decision support systems, nursing vigilance, and physician prescribing patterns to reduce preventable adverse drug events: a structured evidence-based narrative review on human-AI interface in medication safety.Frontiers in digital health · 2026Review
- Article
- Assessing Medication CDS Usability: Pilot Results from 10 Outpatient Clinics.Applied clinical informatics · 2025Article
- Using technology acceptance model to explore physicians' perspectives of clinical decision support system alerts.BMJ health & care informatics · 2025Article
- Evaluation of a Best-Practice Advisory for Primary Aldosteronism Screening.JAMA internal medicine · 2024Article
- Clinical decision support systems in community pharmacies: a scoping review.Journal of the American Medical Informatics Association : JAMIA · 2023Article
- Inpatient EHR User Experience and Hospital EHR Safety Performance.JAMA network open · 2023Article
- Distinct components of alert fatigue in physicians' responses to a noninterruptive clinical decision support alert.Journal of the American Medical Informatics Association : JAMIA · 2022Article
- Impact of Kidney Failure Risk Prediction Clinical Decision Support on Monitoring and Referral in Primary Care Management of CKD: A Randomized Pragmatic Clinical Trial.Kidney medicine · 2022Article
- Clinical Decision Support Stewardship: Best Practices and Techniques to Monitor and Improve Interruptive Alerts.Applied clinical informatics · 2022Review
- The potential for leveraging machine learning to filter medication alerts.Journal of the American Medical Informatics Association : JAMIA · 2022Article
- Alerts in Clinical Decision Support Systems (CDSS): A Bibliometric Review and Content Analysis.Healthcare (Basel, Switzerland) · 2022Article
- Modulators Influencing Medication Alert Acceptance: An Explorative Review.Applied clinical informatics · 2022Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
7 authors.
Funding
Abstract
backgroundClinical decision support systems can prevent knowledge-based prescription errors and improve patient outcomes. The clinical effectiveness of these systems, however, is substantially limited by poor user acceptance of presented warnings. To enhance alert acceptance it may be useful to quantify the impact of potential modulators of acceptance.
methodsWe built a logistic regression model to predict alert acceptance of drug-drug interaction (DDI) alerts in three different settings. Ten variables from the clinical and human factors literature were evaluated as potential modulators of provider alert acceptance. ORs were calculated for the impact of knowledge quality, alert display, textual information, prioritization, setting, patient age, dose-dependent toxicity, alert frequency, alert level, and required acknowledgment on acceptance of the DDI alert.
results50,788 DDI alerts were analyzed. Providers accepted only 1.4% of non-interruptive alerts. For interruptive alerts, user acceptance positively correlated with frequency of the alert (OR 1.30, 95% CI 1.23 to 1.38), quality of display (4.75, 3.87 to 5.84), and alert level (1.74, 1.63 to 1.86). Alert acceptance was higher in inpatients (2.63, 2.32 to 2.97) and for drugs with dose-dependent toxicity (1.13, 1.07 to 1.21). The textual information influenced the mode of reaction and providers were more likely to modify the prescription if the message contained detailed advice on how to manage the DDI.
conclusionWe evaluated potential modulators of alert acceptance by assessing content and human factors issues, and quantified the impact of a number of specific factors which influence alert acceptance. This information may help improve clinical decision support systems design.
Indexed as
Identifiers
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.