Trial reportBMC medical informatics and decision making2017
The effect of a test ordering software intervention on the prescription of unnecessary laboratory tests - a randomized controlled trial.
Trial report in BMC medical informatics and decision making, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers, 3 of them syntheses that pooled 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.
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
13 citing papers in PubMed, 3 syntheses or guidelines pooled it, 26 citations in OpenAlex.
- Digital tracking, provider decision support systems, and targeted client communication via mobile devices to improve primary health care.The Cochrane database of systematic reviews · 2025Pooled it
- Reducing Potentially Inappropriate Prescriptions for Older Patients Using Computerized Decision Support Tools: Systematic Review.Journal of medical Internet research · 2019Pooled 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
- The role of electronic health records systems in de-implementing low-value care in primary care: a scoping review.Implementation science communications · 2025Review
- Promoting Nordic 'Green Care Practices'.Scandinavian journal of primary health care · 2025Article
- Strategies for de-implementation of low-value care-a scoping review.Implementation science : IS · 2022Article
- Randomized controlled trials in de-implementation research: a systematic scoping review.Implementation science : IS · 2022Article
- [The problem of medical overuse : Finding a definition and solutions].Der Internist · 2021Review
- Article
- Primary care use of laboratory tests in Northern Ireland's Western Health and Social Care Trust: a cross-sectional study.BMJ open · 2019Article
- Explaining variations in test ordering in primary care: protocol for a realist review.BMJ open · 2018Article
- Computerised decision to reduce inappropriate medication in the elderly: a systematic review with meta-analysis protocol.BMJ open · 2018Article
- Diagnostic and laboratory test ordering in Northern Portuguese Primary Health Care: a cross-sectional study.BMJ open · 2017Article
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 at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe way software for electronic health records and laboratory tests ordering systems are designed may influence physicians' prescription. A randomised controlled trial was performed to measure the impact of a diagnostic and laboratory tests ordering system software modification.
methodsParticipants were family physicians working and prescribing diagnostic and laboratory tests. The intervention group had a modified software with a basic shortcut menu changes, where some tests were withdrawn or added, and with the implementation of an evidence-based decision support based on United States Preventive Services Task Force (USPSTF) recommendations. This intervention group was compared with usual software (control group). The outcomes were the number of tests prescribed from those: withdrawn from the basic menu; added to the basic menu; marked with green dots (USPSTF's grade A and B); and marked with red dots (USPSTF's grade D).
resultsComparing the monthly average number of tests prescribed before and after the software modification, from those tests that were withdrawn from the basic menu, the control group prescribed 33.8 tests per 100 consultations before and 30.8 after (p = 0075); the intervention group prescribed 31.3 before and 13.9 after (p < 0001). Comparing the tests prescribed between both groups during the intervention, from those tests that were withdrawn from the basic menu, the intervention group prescribed a monthly average of 14.0 vs. 29.3 tests per 100 consultations in the control group (p < 0.001). From those tests that are USPSTF's grade A and B, intervention group prescribed 66.8 vs. 74.1 tests per 100 consultations in the control group (p = 0.070). From those tests categorised as USPSTF grade D, the intervention group prescribed an average of 9.8 vs. 11.8 tests per 100 consultations in the control group (p = 0.003).
conclusionsRemoving unnecessary tests from a quick shortcut menu of the diagnosis and laboratory tests ordering system had a significant impact and reduced unnecessary prescription of tests. The fact that it was not possible to perform the randomization at the family physicians' level, but only of the computer servers is a limitation of our study. Future research should assess the impact of different tests ordering systems during longer periods.
trial registrationISRCTN45427977 , May 1
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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.