Evidence map›Paper›PMID 31811650›Full record

Trial reportMuscle & nerve2020

Randomized controlled trial of a clinical decision support system for painful polyneuropathy.

Evan L Reynolds, James F Burke, Mousumi Banerjee, Brian C Callaghan

Open access · bronzeAbstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Muscle & nerve, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed, 2 pooled it
0.8field-weighted citation impact, top 26% of its field
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

6 citing papers in PubMed, 2 syntheses or guidelines pooled it, 18 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. Review
  4. Article
  5. Article
  6. Review
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

4 authors at 2 institutions in 1 country.

Evan L ReynoldsHealth Services Research Program, Department of Neurology, University of Michigan, Ann Arbor, Michigan.ORCID 0000-0002-0138-8436
James F BurkeHealth Services Research Program, Department of Neurology, University of Michigan, Ann Arbor, Michigan.
Mousumi BanerjeeSchool of Public Health, University of Michigan, Ann Arbor, Michigan.
Brian C CallaghanHealth Services Research Program, Department of Neurology, University of Michigan, Ann Arbor, Michigan.
Michigan Department of Health and Human Services · USUniversity of Michigan · US

Funding

Reducing Racial Disparities in Post-Stroke Disability in the ElderlyR01MD008879 · NIMHD · UNIVERSITY OF MICHIGAN AT ANN ARBOR · PI BURKE, JAMES FRANCIS, SKOLARUS, LESLI ELIZABETH · 2014 to 2018
$1.9M
Using Outcomes Analyses to Inform Implementation of NINDS Clinical TrialsK08NS082597 · NINDS · UNIVERSITY OF MICHIGAN AT ANN ARBOR · PI BURKE, JAMES FRANCIS · 2013 to 2017
$948k
The Impact of the Metabolic Syndrome on NeuropathyK23NS079417 · NINDS · UNIVERSITY OF MICHIGAN AT ANN ARBOR · PI CALLAGHAN, BRIAN CHRISTOPHER · 2013 to 2017
$939k
CSRD VA I01 CX001504NIMHD NIH HHS R01 MD008879NINDS NIH HHS K08 NS082597NINDS NIH HHS K23 NS079417
6 · The paper itself

Abstract

introductionDespite the existence of guidelines, painful neuropathy is often inappropriately treated. We sought to determine the effectiveness of a clinical decision support system on guideline-recommended medication use.

methodsWe randomized neurology providers, stratified by subspecialty, to a best practice alert (BPA) linked to a Smartset or a BPA alone when seeing patients with neuropathy. The primary outcome was the proportion of patients with uncontrolled nerve pain prescribed a guideline-recommended medication. Generalized estimating equations were used to assess effectiveness.

resultsSeventy-five neurology providers (intervention 38, control 37) treated 2697 patients with neuropathy (intervention 1026, control 671). Providers did not acknowledge the BPA in 1928 (71.5%) visits. Only four of eight intervention arm neurologists who treated patients with uncontrolled nerve pain opened the Smartset. The intervention was not associated with guideline-recommended medication use (odds ratio 0.52, 0.18-1.48; intervention 52%, control 54.8%). DISCUSSION: Our intervention did not improve prescribing practices for painful neuropathy. Physicians typically ignored the BPAs/Smartset; therefore, future studies should mandate their use or employ alternate strategies.

Indexed as

Decision Support Systems, ClinicalPractice Guidelines as TopicAdultAgedAnalgesics, Non-NarcoticAnalgesics, OpioidFemaleGuideline AdherenceHumansMaleMiddle AgedNeuralgiaNeurologistsNurse PractitionersPain ManagementPolyneuropathiesAnalgesics, Non-NarcoticAnalgesics, Opioidbest practice alertclinical decision support systemsneuropathic painneuropathyopioidrandomized controlled trial

Identifiers

PMID31811650
PMCPMC12416506
OpenAlexW2993062603

What OpenQuestion holds

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Read underepoch 390

Registered trials

None linked

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.