Evidence map›Paper›PMID 22534081›Full record

ArticleJournal of the American Medical Informatics Association : JAMIA2012

Evaluating alert fatigue over time to EHR-based clinical trial alerts: findings from a randomized controlled study.

Peter J Embi, Anthony C Leonard

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Journal of the American Medical Informatics Association : JAMIA, 2012. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 122 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
122citing papers in PubMed, 3 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

122 citing papers in PubMed, 3 syntheses or guidelines pooled it.

  1. Strategies to improve recruitment to randomised trials.The Cochrane database of systematic reviews · 2018
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  20. Comparing survey delivery methods in healthcare: A randomized study.Journal of clinical and translational science · 2025
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62 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

2 authors.

Peter J EmbiDepartment of Biomedical Informatics, College of Medicine, The Ohio State University, Columbus, Ohio 43210, USA. peter.embi@osumc.edu
Anthony C Leonard

Funding

Evaluating EHR-based, Point-of-Care Trial Recruitment Across Clinical SettingsR01LM009533 · NLM · UNIVERSITY OF CINCINNATI · PI EMBI, PETER J. · 2008 to 2010
$958k
NLM NIH HHS R01 LM009533NLM NIH HHS R01-LM009533
6 · The paper itself

Abstract

objectiveInadequate participant recruitment is a major problem facing clinical research. Recent studies have demonstrated that electronic health record (EHR)-based, point-of-care, clinical trial alerts (CTA) can improve participant recruitment to certain clinical research studies. Despite their promise, much remains to be learned about the use of CTAs. Our objective was to study whether repeated exposure to such alerts leads to declining user responsiveness and to characterize its extent if present to better inform future CTA deployments.

methodsDuring a 36-week study period, we systematically documented the response patterns of 178 physician users randomized to receive CTAs for an ongoing clinical trial. Data were collected on: (1) response rates to the CTA; and (2) referral rates per physician, per time unit. Variables of interest were offset by the log of the total number of alerts received by that physician during that time period, in a Poisson regression.

resultsResponse rates demonstrated a significant downward trend across time, with response rates decreasing by 2.7% for each advancing time period, significantly different from zero (flat) (p<0.0001). Even after 36 weeks, response rates remained in the 30%-40% range. Subgroup analyses revealed differences between community-based versus university-based physicians (p=0.0489). DISCUSSION: CTA responsiveness declined gradually over prolonged exposure, although it remained reasonably high even after 36 weeks of exposure. There were also notable differences between community-based versus university-based users.

conclusionsThese findings add to the limited literature on this form of EHR-based alert fatigue and should help inform future tailoring, deployment, and further study of CTAs.

Indexed as

Electronic Health RecordsFatiguePatient SelectionRandomized Controlled Trials as TopicHumansPhysiciansUser-Computer Interface

Identifiers

PMID22534081
PMCPMC3392862

What OpenQuestion holds

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Registered trials

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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.