Trial reportJournal of the American Medical Informatics Association : JAMIA
Making electronic prescribing alerts more effective: scenario-based experimental study in junior doctors.
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 25 papers, 2 of them syntheses that pooled it.
What it found
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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
25 citing papers in PubMed, 2 syntheses or guidelines pooled 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
- A Systematic Review of Clinical Decision Support Systems for Clinical Oncology Practice.Journal of the National Comprehensive Cancer Network : JNCCN · 2019Pooled it
- Trial
- Alerts in Clinical Decision Support Systems (CDSS): A Bibliometric Review and Content Analysis.Healthcare (Basel, Switzerland) · 2022Article
- Knowledge support for ankle fractures in the Swedish Fracture Register - a qualitative study of physicians' experiences.BMC health services research · 2022Article
- General practitioner and nurse practitioner attitudes towards electronic reminders in primary care: a qualitative analysis.BMJ open · 2021Article
- The Use of a Decision Support System in Swedish Pharmacies to Identify Potential Drug-Related Problems-Effects of a National Intervention Focused on Reviewing Elderly Patients' Prescriptions.Pharmacy (Basel, Switzerland) · 2020Article
- Impact of a "Chart Closure" Hard Stop Alert on Prescribing for Elevated Blood Pressures Among Patients With Diabetes: Quasi-Experimental Study.JMIR medical informatics · 2020Article
- Mixed methods study of medication-related decision support alerts experienced during electronic prescribing for inpatients at an English hospital.European journal of hospital pharmacy : science and practice · 2019Article
- For which clinical rules do doctors want decision support, and why? A survey of Dutch general practitioners.Health informatics journal · 2019Article
- How can clinicians, specialty societies and others evaluate and improve the quality of apps for patient use?BMC medicine · 2018Article
- Primary care provider adherence to an alert for intensification of diabetes blood pressure medications before and after the addition of a "chart closure" hard stop.Journal of the American Medical Informatics Association : JAMIA · 2018Article
- Nonmodal Clinical Decision Support and Antimicrobial Restriction Effects on Rates of Fluoroquinolone Use in Uncomplicated Infections.Applied clinical informatics · 2018Article
- Modeling information flows in clinical decision support: key insights for enhancing system effectiveness.Journal of the American Medical Informatics Association : JAMIA · 2016Article
- How Regrouping Alerts in Computerized Physician Order Entry Layout Influences Physicians' Prescription Behavior: Results of a Crossover Randomized Trial.JMIR human factors · 2016Article
- Potential drug-related problems detected by electronic expert support system: physicians' views on clinical relevance.International journal of clinical pharmacy · 2015Article
- Making pharmacogenomic-based prescribing alerts more effective: A scenario-based pilot study with physicians.Journal of biomedical informatics · 2015Article
- Prescribing pattern of interns: Time for new interventions.Journal of basic and clinical pharmacy · 2014Article
- Applying human factors principles to alert design increases efficiency and reduces prescribing errors in a scenario-based simulation.Journal of the American Medical Informatics Association : JAMIA · 2014Article
- Usability evaluation of pharmacogenomics clinical decision support aids and clinical knowledge resources in a computerized provider order entry system: a mixed methods approach.International journal of medical informatics · 2014Article
Corrections and comments
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Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveExpert authorities recommend clinical decision support systems to reduce prescribing error rates, yet large numbers of insignificant on-screen alerts presented in modal dialog boxes persistently interrupt clinicians, limiting the effectiveness of these systems. This study compared the impact of modal and non-modal electronic (e-) prescribing alerts on prescribing error rates, to help inform the design of clinical decision support systems.
designA randomized study of 24 junior doctors each performing 30 simulated prescribing tasks in random order with a prototype e-prescribing system. Using a within-participant design, doctors were randomized to be shown one of three types of e-prescribing alert (modal, non-modal, no alert) during each prescribing task. MEASUREMENTS: The main outcome measure was prescribing error rate. Structured interviews were performed to elicit participants' preferences for the prescribing alerts and their views on clinical decision support systems.
resultsParticipants exposed to modal alerts were 11.6 times less likely to make a prescribing error than those not shown an alert (OR 11.56, 95% CI 6.00 to 22.26). Those shown a non-modal alert were 3.2 times less likely to make a prescribing error (OR 3.18, 95% CI 1.91 to 5.30) than those not shown an alert. The error rate with non-modal alerts was 3.6 times higher than with modal alerts (95% CI 1.88 to 7.04).
conclusionsBoth kinds of e-prescribing alerts significantly reduced prescribing error rates, but modal alerts were over three times more effective than non-modal alerts. This study provides new evidence about the relative effects of modal and non-modal alerts on prescribing outcomes.
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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.