Evidence map›Paper›PMID 38479736›Full record

ArticleBMJ open2024

Qualitative study of challenges with recruitment of hospitals into a cluster controlled trial of clinical decision support in Australia.

Melissa T Baysari, Bethany Annemarie Van Dort, Kristian Stanceski, Andrew Hargreaves, Wu Yi Zheng, Maria Moran, Richard O Day, Ling Li, Johanna Westbrook, Sarah N Hilmer

Abstract readControlled Clinical TrialMulticenter Study
PubMed Full text at PMC Publisher
In one paragraph

Article in BMJ open, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
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

1 citing paper in PubMed.

  1. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Melissa T BaysariBiomedical Informatics and Digital Health, Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia melissa.baysari@sydney.edu.au.ORCID 0000-0003-1645-9126
Bethany Annemarie Van DortBiomedical Informatics and Digital Health, Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia.ORCID 0000-0003-0052-6400
Kristian StanceskiBiomedical Informatics and Digital Health, Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia.
Andrew HargreaveseHealth NSW, Chatswood, New South Wales, Australia.
Wu Yi ZhengBlack Dog Institute, Randwick, New South Wales, Australia.
Maria MoranBiomedical Informatics and Digital Health, Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia.
Richard O DayDepartment of Clinical Pharmacology & Toxicology, St Vincent's Hospital Sydney, Darlinghurst, New South Wales, Australia.ORCID 0000-0002-6045-6937
Ling LiCentre for Health Systems and Safety Research, Australian Institute of Health Innovation, Faculty of Medicine and Health Sciences, Macquarie University, New South Wales, Australia.ORCID 0000-0002-1642-142X
Johanna WestbrookCentre for Health Systems and Safety Research, Australian Institute of Health Innovation, Faculty of Medicine and Health Sciences, Macquarie University, New South Wales, Australia.ORCID 0000-0003-1083-8192
Sarah N HilmerClinical Pharmacology and Aged Care, Royal North Shore Hospital, St Leonards, New South Wales, Australia.

Funding

Medical Research Council
6 · The paper itself

Abstract

objectiveTo identify barriers to hospital participation in controlled cluster trials of clinical decision support (CDS) and potential strategies for addressing barriers.

designQualitative descriptive design comprising semistructured interviews.

settingFive hospitals in New South Wales and one hospital in Queensland, Australia.

participantsSenior hospital staff, including department directors, chief information officers and those working in health informatics teams.

results20 senior hospital staff took part. Barriers to hospital-level recruitment primarily related to perceptions of risk associated with not implementing CDS as a control site. Perceived risks included reductions in patient safety, reputational risk and increased likelihood that benefits would not be achieved following electronic medical record (EMR) implementation without CDS alerts in place. Senior staff recommended clear communication of trial information to all relevant stakeholders as a key strategy for boosting hospital-level participation in trials.

conclusionHospital participation in controlled cluster trials of CDS is hindered by perceptions that adopting an EMR without CDS is risky for both patients and organisations. The improvements in safety expected to follow CDS implementation makes it challenging and counterintuitive for hospitals to implement EMR without incorporating CDS alerts for the purposes of a research trial. To counteract these barriers, clear communication regarding the evidence base and rationale for a controlled trial is needed.

Indexed as

Decision Support Systems, ClinicalAustraliaHospitalsHumansQualitative ResearchQueenslandHealth informaticsHospitalsQUALITATIVE RESEARCH

Identifiers

PMID38479736
PMCPMC10936458

What OpenQuestion holds

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LicenceCC BY-NC
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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.