Evidence map›Paper›PMID 21824383›Full record

SynthesisImplementation science : IS2011

Computerized clinical decision support systems for drug prescribing and management: a decision-maker-researcher partnership systematic review.

Brian J Hemens, Anne Holbrook, Marita Tonkin, Jean A Mackay, Lorraine Weise-Kelly, Tamara Navarro, Nancy L Wilczynski, R Brian Haynes, CCDSS Systematic Review Team

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

Synthesis in Implementation science : IS, 2011. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 70 papers, 9 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
70citing papers in PubMed, 9 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

70 citing papers in PubMed, 9 syntheses or guidelines pooled it.

  1. Alert fatigue measurement in clinical decision support: a systematic review.Journal of the American Medical Informatics Association : JAMIA · 2026
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  9. Computer decision support systems for asthma: a systematic review.NPJ primary care respiratory medicine · 2014
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10 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

9 authors.

Brian J HemensHealth Information Research Unit, Department of Clinical Epidemiology and Biostatistics, McMaster University, 1280 Main Street West, Hamilton, ON, Canada.
Anne Holbrook
Marita Tonkin
Jean A Mackay
Lorraine Weise-Kelly
Tamara Navarro
Nancy L Wilczynski
R Brian Haynes
CCDSS Systematic Review Team

Funding

Canadian Institutes of Health Research KRS 91791
6 · The paper itself

Abstract

backgroundComputerized clinical decision support systems (CCDSSs) for drug therapy management are designed to promote safe and effective medication use. Evidence documenting the effectiveness of CCDSSs for improving drug therapy is necessary for informed adoption decisions. The objective of this review was to systematically review randomized controlled trials assessing the effects of CCDSSs for drug therapy management on process of care and patient outcomes. We also sought to identify system and study characteristics that predicted benefit.

methodsWe conducted a decision-maker-researcher partnership systematic review. We updated our earlier reviews (1998, 2005) by searching MEDLINE, EMBASE, EBM Reviews, Inspec, and other databases, and consulting reference lists through January 2010. Authors of 82% of included studies confirmed or supplemented extracted data. We included only randomized controlled trials that evaluated the effect on process of care or patient outcomes of a CCDSS for drug therapy management compared to care provided without a CCDSS. A study was considered to have a positive effect (i.e., CCDSS showed improvement) if at least 50% of the relevant study outcomes were statistically significantly positive.

resultsSixty-five studies met our inclusion criteria, including 41 new studies since our previous review. Methodological quality was generally high and unchanged with time. CCDSSs improved process of care performance in 37 of the 59 studies assessing this type of outcome (64%, 57% of all studies). Twenty-nine trials assessed patient outcomes, of which six trials (21%, 9% of all trials) reported improvements.

conclusionsCCDSSs inconsistently improved process of care measures and seldomly improved patient outcomes. Lack of clear patient benefit and lack of data on harms and costs preclude a recommendation to adopt CCDSSs for drug therapy management.

Indexed as

Biomedical ResearchCooperative BehaviorPrescription DrugsAlgorithmsConsumer BehaviorDecision Support Systems, ClinicalDisease ManagementDrug-Related Side Effects and Adverse ReactionsEvidence-Based MedicineGlobal HealthHumansMonitoring, PhysiologicPractice Patterns, Physicians'United StatesUser-Computer InterfacePrescription Drugs

Identifiers

PMID21824383
PMCPMC3179735

What OpenQuestion holds

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LicenceCC BY
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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.