Trial reportJournal of the American Medical Informatics Association : JAMIA
Improving completeness of electronic problem lists through clinical decision support: a randomized, controlled trial.
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. It is linked to trial NCT01105923 (Making Accurate Problem Lists in the EHR), which is not on this map. Cited by 48 papers, 5 of them syntheses that pooled it.
What it found
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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.
Making Accurate Problem Lists in the EHR
Who cites it
48 citing papers in PubMed, 5 syntheses or guidelines pooled it.
- Electronic Health Record Nudges and Health Care Quality and Outcomes in Primary Care: A Systematic Review.JAMA network open · 2024Pooled it
- Decision-support tools via mobile devices to improve quality of care in primary healthcare settings.The Cochrane database of systematic reviews · 2021Pooled it
- Computerised clinical decision support systems and absolute improvements in care: meta-analysis of controlled clinical trials.BMJ (Clinical research ed.) · 2020Pooled it
- Electronic problem lists: a thematic analysis of a systematic literature review to identify aspects critical to success.Journal of the American Medical Informatics Association : JAMIA · 2018Pooled 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
- User Actions within a Clinical Decision Support Alert for the Management of Hypertension in Chronic Kidney Disease.Applied clinical informatics · 2025Trial
- A multi-site randomized trial of a clinical decision support intervention to improve problem list completeness.Journal of the American Medical Informatics Association : JAMIA · 2023Trial
- Design of a cluster-randomized trial of electronic health record-based tools to address overweight and obesity in primary care.Clinical trials (London, England) · 2015Trial
- Diabetes Screening Reminder for Women With Prior Gestational Diabetes: A Randomized Controlled Trial.Obstetrics and gynecology · 2015Trial
- Patient-specific computer-based decision support in primary healthcare--a randomized trial.Implementation science : IS · 2014Trial
- Multi-Task Training with In-Domain Language Models for Diagnostic Reasoning.Proceedings of the conference. Association for Computational Linguistics. Meeting · 2023Article
- Inaccurate recording of routinely collected data items influences identification of COVID-19 patients.International journal of medical informatics · 2022Article
- End-users feedback and perceptions associated with the implementation of a clinical-rule based Check of Medication Appropriateness service.BMC medical informatics and decision making · 2022Article
- Indication alerts to improve problem list documentation.Journal of the American Medical Informatics Association : JAMIA · 2022Article
- Article
- Building a Shared, Scalable, and Sustainable Source for the Problem-Oriented Medical Record: Developmental Study.JMIR medical informatics · 2021Article
- Multilevel Follow-up of Cancer Screening (mFOCUS): Protocol for a multilevel intervention to improve the follow-up of abnormal cancer screening test results.Contemporary clinical trials · 2021Article
- A multifaceted clinical decision support intervention to improve adherence to thromboprophylaxis guidelines.International journal of clinical pharmacy · 2021Article
- Clinical data sharing improves quality measurement and patient safety.Journal of the American Medical Informatics Association : JAMIA · 2021Article
- Electronic Health Records-Based Cardio-Oncology Registry for Care Gap Identification and Pragmatic Research: Procedure and Observational Study.JMIR cardio · 2021Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
9 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundAccurate clinical problem lists are critical for patient care, clinical decision support, population reporting, quality improvement, and research. However, problem lists are often incomplete or out of date.
objectiveTo determine whether a clinical alerting system, which uses inference rules to notify providers of undocumented problems, improves problem list documentation. STUDY DESIGN AND
methodsInference rules for 17 conditions were constructed and an electronic health record-based intervention was evaluated to improve problem documentation. A cluster randomized trial was conducted of 11 participating clinics affiliated with a large academic medical center, totaling 28 primary care clinical areas, with 14 receiving the intervention and 14 as controls. The intervention was a clinical alert directed to the provider that suggested adding a problem to the electronic problem list based on inference rules. The primary outcome measure was acceptance of the alert. The number of study problems added in each arm as a pre-specified secondary outcome was also assessed. Data were collected during 6-month pre-intervention (11/2009-5/2010) and intervention (5/2010-11/2010) periods.
results17,043 alerts were presented, of which 41.1% were accepted. In the intervention arm, providers documented significantly more study problems (adjusted OR=3.4, p<0.001), with an absolute difference of 6277 additional problems. In the intervention group, 70.4% of all study problems were added via the problem list alerts. Significant increases in problem notation were observed for 13 of 17 conditions.
conclusionProblem inference alerts significantly increase notation of important patient problems in primary care, which in turn has the potential to facilitate quality improvement.
trial registrationClinicalTrials.gov: NCT01105923.
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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.