ArticleJournal of the American Medical Informatics Association : JAMIA2022
Distinct components of alert fatigue in physicians' responses to a noninterruptive clinical decision support alert.
Article in Journal of the American Medical Informatics Association : JAMIA, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers, 1 of them a synthesis 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.
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Who cites it
20 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Alert fatigue measurement in clinical decision support: a systematic review.Journal of the American Medical Informatics Association : JAMIA · 2026Pooled it
- Trial
- Implementing calculated globulin screening for immunodeficiencies: The benefits and challenges.Journal of human immunity · 2026Review
- Optimizing Clinical Decision Support for Antibiotic Prescribing in Pediatric Acute Respiratory Tract Infections: A Usability Study.Applied clinical informatics · 2026Article
- Experiences of Alert Fatigue and Its Contributing Factors in Hospitals: Qualitative Study.Journal of medical Internet research · 2026Article
- Machine learning and multi-omics technologies for precision cardiovascular medicine: advancing diagnosis, risk prediction, and therapeutic guidance.Frontiers in cardiovascular medicine · 2026Review
- Application of Nudges to Design Clinical Decision Support Tools: Systematic Approach Guided by Implementation Science.Journal of medical Internet research · 2025Article
- Treating Childhood Obesity: Building and Evaluating Evidence-Based Models of Integrated Care.Journal of the Endocrine Society · 2025Review
- Implementation of Passive Deterioration Index Alerts in an Intermediate Care Unit: A Failed Early Warning System Strategy.Applied clinical informatics · 2025Article
- Transitioning Ineffective Medications on Hold Alert from Interruptive to Noninterruptive Alert to Decrease Alert Burden.Applied clinical informatics · 2025Article
- Evolution of an Electronic Health Record-Based Alert to Optimize Venous Thromboembolism Prophylaxis.Applied clinical informatics · 2025Article
- The Elements of Style for Interruptive Electronic Health Record Alerts.Applied clinical informatics · 2025Article
- Open LLM-based actionable incidental finding extraction from [Frontiers in digital health · 2025Article
- Exploring Stakeholder Perceptions about Using Artificial Intelligence for the Diagnosis of Rare and Atypical Infections.Applied clinical informatics · 2025Article
- User-Centered Framework for Implementation of Technology (UFIT): Development of an Integrated Framework for Designing Clinical Decision Support Tools Packaged With Tailored Implementation Strategies.Journal of medical Internet research · 2024Article
- Randomized Comparison of Electronic Health Record Alert Types in Eliciting Responses about Prognosis in Gynecologic Oncology Patients.Applied clinical informatics · 2024Article
- Resident-Driven Clinical Decision Support Governance to Improve the Utility of Clinical Decision Support.Applied clinical informatics · 2024Article
- Cognitive task analysis of clinicians' drug-drug interaction management during patient care and implications for alert design.BMJ open · 2023Article
- Advances in Clinical Decision Support Systems: Contributions from the 2022 Literature.Yearbook of medical informatics · 2023Article
- Impact of a Clinical Decision Support Alert on Informed Consent Documentation in the Neonatal Intensive Care Unit.Pediatric quality & safetyArticle
Corrections and comments
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Authors and funding
5 authors.
Funding
Abstract
objectiveClinical decision support (CDS) alerts may improve health care quality but "alert fatigue" can reduce provider responsiveness. We analyzed how the introduction of competing alerts affected provider adherence to a single depression screening alert. MATERIALS AND
methodsWe analyzed the audit data from all occurrences of a CDS alert at a large academic health system. For patients who screen positive for depression during ambulatory visits, a noninterruptive alert was presented, offering a number of relevant documentation actions. Alert adherence was defined as the selection of any option offered within the alert. We assessed the effect of competing clinical guidance alerts presented during the same encounter and the total of all CDS alerts that the same provider had seen in the prior 90 days, on the probability of depression screen alert adherence, adjusting for physician and patient characteristics.
resultsThe depression alert fired during 55 649 office visits involving 418 physicians and 40 474 patients over 41 months. After adjustment, physicians who had seen the most alerts in the prior 90 days were much less likely to respond (adjusted OR highest-lowest quartile, 0.38; 95% CI 0.35-0.42; P < .001). Competing alerts in the same visit further reduced the likelihood of adherence only among physicians in the middle two quartiles of alert exposure in the prior 90 days.
conclusionsAdherence to a noninterruptive depression alert was strongly associated with the provider's cumulative alert exposure over the past quarter. Health systems should monitor providers' recent alert exposure as a measure of alert fatigue.
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