Observational studyEinstein (Sao Paulo, Brazil)2026
Impact of digital automation of institutional pathways on test-ordering patterns in a primary health care.
Observational study in Einstein (Sao Paulo, Brazil), 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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The trial behind it
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Who cites it
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Authors and funding
4 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveTo evaluate the impact of digital automation of institutional pathways on the adherence of test ordering to evidence-based best practices in a primary care setting for obesity.
methodsObservational, single-center, retrospective study comparing the periods before (2023) and after (2024) the implantation of a clinical decision support system. Outcomes: volume of tests adherent to protocols, distribution of ordering mix (entropy/perplexity), and test-specific differences (Poisson rate ratios). Rates per 100 visits were estimated, and incidence rate ratios (IRR) with 95% confidence intervals (95%CI) were estimated. The Mann-Whitney test was used to compare adherent tests per visit, alongside descriptive analyses (top-10 both in absolute and percentage changes).
resultsTotal orders: 347 (before) versus 787 (after); distinct test types: 117 versus 120. Adherent tests: 179 versus 413; IRR=1.63 (95%CI=1.37-1.96; p<0.001). Median of adherent tests per visit: 1.0 (before) versus 3.0 (after) (p=0.027). Perplexity: 70.9 (before) versus 57.6 (after), indicating increased concentration of orders in protocol-based tests. Among the top-10 absolute growth tests, 9/10 were protocol-based; among the top-10 by percentage change, 0/10.
conclusionDigital automation of the pathway was associated with greater adherence to institutional protocols and with a test-ordering pattern more concentrated in core protocol tests.
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