Trial reportJournal of general internal medicine2021
Effect of Outpatient Note Templates on Note Quality: NOTE (Notation Optimization through Template Engineering) Randomized Clinical Trial.
Trial report in Journal of general internal medicine, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT04333238 (Notation Optimization Through Template Engineering), which is not on this map. Cited by 14 papers.
What it found
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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.
Notation Optimization Through Template Engineering
Who cites it
14 citing papers in PubMed.
- Clinicians' rationale for editing ambient AI-drafted clinical notes: persistent challenges and implications for improvement.Journal of the American Medical Informatics Association : JAMIA · 2026Article
- Enhancing Resident Note Documentation: A Quality Improvement Initiative to Accurately Capture Patient Complexity.American journal of medicine open · 2025Article
- A fiscally sound, evidenced-based solution to conquering the complexity of physician billing guidelines: A physician-centric note template.Health information management : journal of the Health Information Management Association of Australia · 2025Article
- Estimating depression severity in narrative clinical notes using large language models.Journal of affective disorders · 2025Article
- The Impact of Diagnosis-Specific Plan Templates on Admission Note Writing Time: A Quality Improvement Initiative.Journal of graduate medical education · 2024Article
- Time and Note Characteristic Effects of an Electronic Health Record Template for Internal Medicine Resident Notes.Journal of graduate medical education · 2024Article
- Charting Tomorrow's Healthcare: A Traditional Literature Review for an Artificial Intelligence-Driven Future.Cureus · 2024Review
- Comparison of medical documentation between pharmacist-led anticoagulation clinics and physician-led anticoagulation clinics: A retrospective study.Saudi pharmaceutical journal : SPJ : the official publication of the Saudi Pharmaceutical Society · 2023Article
- Novel Note Templates to Enhance Signal and Reduce Noise in Medical Documentation: Prospective Improvement Study.JMIR formative research · 2023Article
- Changes in Primary Care Quality Associated With Implementation of the Veterans Health Administration Preventive Health Inventory.JAMA network open · 2023Article
- Patterns of Surgical Risk Assessment at a Tertiary Academic Medical Center.The Brown journal of hospital medicine · 2023Article
- Cocreating the ICU-PAUSE Tool for Intensive Care Unit-Ward Transitions.ATS scholar · 2022Article
- The Impact of Structured and Standardized Documentation on Documentation Quality; a Multicenter, Retrospective Study.Journal of medical systems · 2022Article
- Clinical Thinking via Electronic Note Templates: Who Benefits?Journal of general internal medicine · 2021Article
Corrections and comments
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Authors and funding
8 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThis is the first randomized controlled trial evaluating the impact of note template design on note quality using a simulated patient encounter and a validated assessment tool.
objectiveTo compare note quality between two different templates using a novel randomized clinical simulation process.
designA randomized non-blinded controlled trial of a standard note template versus redesigned template.
participantsPGY 1-3 IM residents.
interventionsResidents documented the simulated patient encounter using one of two templates. The standard template was modeled after the usual outpatient progress note. The new template placed the assessment and plan section in the beginning, grouped subjective data into the assessment, and deemphasized less useful elements. MAIN MEASURES: Note length; time to note completion; note template evaluation by resident authors; note evaluation by faculty reviewers. KEY
results36 residents participated, 19 randomized to standard template, 17 to new. New template generated shorter notes (103 vs 285 lines, p < 0.001) that took the same time to complete (19.8 vs 21.6 min, p = 0.654). Using a 5-point Likert scale, residents considered new notes to have increased visual appeal (4 vs 3, p = 0.05) and less redundancy and clutter (4 vs 3, p = 0.006). Overall template satisfaction was not statistically different. Faculty reviewers rated the standard note more up-to-date (4.3 vs 2.7, p = 0.001), accurate (3.9 vs 2.6, p = 0.003), and useful (4 vs 2.8, p = 0.002), but less organized (3.3 vs 4.5, p < 0.001). Total quality was not statistically different.
conclusionsResidents rated the new note template more visually appealing, shorter, and less cluttered. Faculty reviewers rated both note types equivalent in the overall quality but rated new notes inferior in terms of accuracy and usefulness though better organized. This study demonstrates a novel method of a simulated clinical encounter to evaluate note templates before the introduction into practice.
trial registrationClinicalTrials.gov ID: NCT04333238.
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