Trial reportJournal of the American Medical Informatics Association : JAMIA2018
Integration of physical abuse clinical decision support into the electronic health record at a Tertiary Care Children's Hospital.
Trial report in Journal of the American Medical Informatics Association : JAMIA, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers, 5 of them syntheses that pooled it.
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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
20 citing papers in PubMed, 5 syntheses or guidelines pooled it.
- The role of information systems in emergency department decision-making-a literature review.Journal of the American Medical Informatics Association : JAMIA · 2024Pooled it
- Conceptualizing clinical decision support as complex interventions: a meta-analysis of comparative effectiveness trials.Journal of the American Medical Informatics Association : JAMIA · 2022Pooled it
- Extracting social determinants of health from electronic health records using natural language processing: a systematic review.Journal of the American Medical Informatics Association : JAMIA · 2021Pooled it
- Predictive value of indicators for identifying child maltreatment and intimate partner violence in coded electronic health records: a systematic review and meta-analysis.Archives of disease in childhood · 2021Pooled 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
- Antibiotic clinical decision support for pneumonia in the ED: A randomized trial.Journal of hospital medicine · 2023Trial
- Improving the evaluation of non-accidental trauma across multiple specialties at a single institution.BMJ open quality · 2025Article
- Identifying Child Abuse in Patients With Femur Fractures Through Pathway Compliance: A Pilot Study.Cureus · 2024Article
- Stressful life events in electronic health records: a scoping review.Journal of the American Medical Informatics Association : JAMIA · 2024Article
- Developing and Testing the Usability of a Novel Child Abuse Clinical Decision Support System: Mixed Methods Study.Journal of medical Internet research · 2024Article
- Stressful life events in electronic health records: a scoping review.Research square · 2023Article
- Disseminating child abuse clinical decision support among commercial electronic health records: Effects on clinical practice.JAMIA open · 2023Article
- The Effect of Implementation of Guideline Order Bundles Into a General Admission Order Set on Clinical Practice Guideline Adoption: Quasi-Experimental Study.JMIR medical informatics · 2023Article
- Electronic Health Record Tools to Identify Child Maltreatment: Scoping Literature Review and Key Informant Interviews.Academic pediatrics · 2022Article
- The influence of integrating clinical practice guideline order bundles into a general admission order set on guideline adoption.JAMIA open · 2021Article
- Clinical evaluation and management of children with suspected physical abuse.Pediatric radiology · 2021Review
- Dissemination of child abuse clinical decision support: Moving beyond a single electronic health record.International journal of medical informatics · 2021Article
- Combatting human trafficking in the United States: how can medical informatics help?Journal of the American Medical Informatics Association : JAMIA · 2021Article
- Integration of physical abuse clinical decision support at 2 general emergency departments.Journal of the American Medical Informatics Association : JAMIA · 2019Article
- Recognizing Nonaccidental Trauma in a Pediatric Tertiary Hospital: A Quality Improvement Imperative.Pediatric quality & safetyArticle
Corrections and comments
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Authors and funding
7 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Objective: To evaluate the effect of a previously validated electronic health record-based child abuse trigger system on physician compliance with clinical guidelines for evaluation of physical abuse. Methods: A randomized controlled trial (RCT) with comparison to a preintervention group was performed. RCT-experimental subjects' providers received alerts with a direct link to a physical abuse-specific order set. RCT-control subjects' providers had no alerts, but could manually search for the order set. Preintervention subjects' providers had neither alerts nor access to the order set. Compliance with clinical guidelines was calculated. Results: Ninety-nine preintervention subjects and 130 RCT subjects (73 RCT-experimental and 57 RCT-control) met criteria to undergo a physical abuse evaluation. Full compliance with clinical guidelines was 84% pre-intervention, 86% in RCT-control group, and 89% in RCT-experimental group. The physical abuse order set was used 43 times during the 7-month RCT. When the abuse order set was used, full compliance was 100%. The proportion of cases in which there was partial compliance decreased from 10% to 3% once the order set became available (P = .04). Male gender, having >10 years of experience and completion of a pediatric emergency medicine fellowship were associated with increased compliance. Discussion/Conclusion: A child abuse clinical decision support system comprised of a trigger system, alerts and a physical abuse order set was quickly accepted into clinical practice. Use of the physical abuse order set always resulted in full compliance with clinical guidelines. Given the high baseline compliance at our site, evaluation of this alert system in hospitals with lower baseline compliance rates will be more valuable in assessing the efficacy in adherence to clinical guidelines for the evaluation of suspected child abuse.
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