Evidence map›Paper›PMID 25322302›Full record

SynthesisAmerican journal of public health2014

Effectiveness of computerized decision support systems linked to electronic health records: a systematic review and meta-analysis.

Lorenzo Moja, Koren H Kwag, Theodore Lytras, Lorenzo Bertizzolo, Linn Brandt, Valentina Pecoraro, Giulio Rigon, Alberto Vaona, Francesca Ruggiero, Massimo Mangia and 3 more

Registry-linked trialAbstract readMeta-AnalysisSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in American journal of public health, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT02577198 (Implementing an Evidence-based Computerized Decision Support System Linked to Electronic Health Records to Improve Patient Care in a General Hospital), which is not on this map. Cited by 144 papers, 20 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
144citing papers in PubMed, 20 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.

NCT02577198 nacompletednot on this mapstarted 2015, after this paper: background citation

Implementing an Evidence-based Computerized Decision Support System Linked to Electronic Health Records to Improve Patient Care in a General Hospital

TypeinterventionalSponsorI.R.C.C.S Ospedale Galeazzi-Sant'AmbrogioRan2015 to 2017Enrolled6,479ConditionsPhysician's RoleArmsMedilogy Decision Support System (MediDSS)
3 · Its place in the literature

Who cites it

144 citing papers in PubMed, 20 syntheses or guidelines pooled it.

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  10. A systematic review of theoretical constructs in CDS literature.BMC medical informatics and decision making · 2021
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  13. Decision support tools to improve cancer diagnostic decision making in primary care: a systematic review.The British journal of general practice : the journal of the Royal College of General Practitioners · 2019
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84 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

13 authors.

Lorenzo MojaLorenzo Moja is with the Department of Biomedical Sciences for Health, University of Milan, and the Unit of Clinical Epidemiology, IRCCS Orthopedic Institute Galeazzi, Milan, Italy. Koren H. Kwag is with the Unit of Clinical Epidemiology, IRCCS Orthopedic Institute Galeazzi, Milan. Theodore Lytras is with the Department of Epidemiological Surveillance and Intervention, Hellenic Centre for Disease Control and Prevention, Athens, Greece, the Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain, and the Department of Experimental and Health Sciences, Universitat Pompeu Fabra, Barcelona. Lorenzo Bertizzolo and Francesca Ruggiero are with the Department of Biomedical Sciences for Health, University of Milan. Linn Brandt is with the Department of Internal Medicine, Inland Hospital Trust, Oslo, Norway, the Department of Internal Medicine, Diakonhjemmet Hospital, Oslo, and HELSAM, University of Oslo. Valentina Pecoraro is with the University of Milan. Giulio Rigon and Alberto Vaona are with Azienda ULSS 20, Verona, Italy. Massimo Mangia is with Medilogy SRL, Milan. Alfonso Iorio is with the Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Ontario. Ilkka Kunnamo is with Duodecim Medical Publications Ltd, Helsinki, Finland. Stefanos Bonovas is with the Laboratory of Drug Regulatory Policies, IRCCS Mario Negri Institute for Pharmacological Research, Milan, and the Department of Pharmacology, School of Medicine, University of Athens, Athens.
Koren H Kwag
Theodore Lytras
Lorenzo Bertizzolo
Linn Brandt
Valentina Pecoraro
Giulio Rigon
Alberto Vaona
Francesca Ruggiero
Massimo Mangia
Alfonso Iorio
Ilkka Kunnamo
Stefanos Bonovas

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

We systematically reviewed randomized controlled trials (RCTs) assessing the effectiveness of computerized decision support systems (CDSSs) featuring rule- or algorithm-based software integrated with electronic health records (EHRs) and evidence-based knowledge. We searched MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials, and Cochrane Database of Abstracts of Reviews of Effects. Information on system design, capabilities, acquisition, implementation context, and effects on mortality, morbidity, and economic outcomes were extracted. Twenty-eight RCTs were included. CDSS use did not affect mortality (16 trials, 37395 patients; 2282 deaths; risk ratio [RR] = 0.96; 95% confidence interval [CI] = 0.85, 1.08; I(2) = 41%). A statistically significant effect was evident in the prevention of morbidity, any disease (9 RCTs; 13868 patients; RR = 0.82; 95% CI = 0.68, 0.99; I(2) = 64%), but selective outcome reporting or publication bias cannot be excluded. We observed differences for costs and health service utilization, although these were often small in magnitude. Across clinical settings, new generation CDSSs integrated with EHRs do not affect mortality and might moderately improve morbidity outcomes.

Indexed as

Decision Support TechniquesElectronic Health RecordsQuality Assurance, Health CareAlgorithmsHumansMortalityRandomized Controlled Trials as TopicSoftware

Identifiers

PMID25322302
PMCPMC4232126

What OpenQuestion holds

Textmetadata
Read underepoch 390

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.