ArticleJournal of medical Internet research2021
Development, Validation, and Assessment of Clinical Impact of Real-time Alerts to Detect Inpatient As-Needed Opioid Orders With Duplicate Indications: Prospective Study.
Article in Journal of medical Internet research, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
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
2 citing papers in PubMed, 3 citations in OpenAlex.
- Post-implementation optimization of medication alerts in hospital computerized provider order entry systems: a scoping review.Journal of the American Medical Informatics Association : JAMIA · 2023Article
- Clinical Decision Support Systems: Contributions from 2021.Yearbook of medical informatics · 2022Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
2 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundAs-needed (PRN) opioid orders with duplicate indications can lead to medication errors and opioid-related adverse drug events.
objectiveThe objective of our study was to build and validate real-time alerts that detect duplicate PRN opioid orders and assist clinicians in optimizing the safety of opioid orders.
methodsThis single-center, prospective study used an iterative, 3-step process to refine alert performance by advancing from small sample evaluations of positive predictive values (PPVs) (step 1) through intensive evaluations of accuracy (step 2) to evaluations of clinical impact (step 3). Validation cohorts were randomly sampled from eligible patients for each step.
resultsDuring step 1, the PPV was 100% (one-sided, 97.5% CI 70%-100%) for moderate and severe pain alerts. During step 2, duplication of 1 or more PRN opioid orders was identified for 17% (34/201; 95% CI, 12%-23%) of patients during chart review. This bundle of alerts showed 94% sensitivity (95% CI 80%-99%) and 96% specificity (95% CI 92%-98%) for identifying patients who had duplicate PRN opioid orders. During step 3, at least 1 intervention was made to the medication profile for 77% (46/60; 95% CI 64%-87%) of patients, and at least 1 inappropriate duplicate PRN opioid order was discontinued for 53% (32/60; 95% CI 40%-66%) of patients.
conclusionsThe bundle of alerts developed in this study was validated against chart review by a pharmacist and identified patients who benefited from medication safety interventions to optimize PRN opioid orders.
Indexed as
Identifiers
What OpenQuestion holds
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.