Effects of computer-based clinical decision support systems on physician performance and patient outcomes: A systematic review

JAMA

Volumn 280, Issue 15, 1998, Pages 1339-1346

  Hunt, Dereck L ^a   Haynes, R Brian ^a,b   Hanna, Steven E ^a   Smith, Kristina ^a  

^a MCMASTER UNIVERSITY   (Canada)

^b MCMASTER UNIVERSITY MEDICAL CENTRE   (Canada)

Author keywords

[No Author keywords available]

Indexed keywords

AMINOGLYCOSIDE ANTIBIOTIC AGENT; AMINOPHYLLINE; ANTICOAGULANT AGENT; HEPARIN; LIDOCAINE; THEOPHYLLINE;

ANTIBIOTIC THERAPY; ANTICOAGULANT THERAPY; BLEEDING; COMPUTER SYSTEM; DRUG INDUCED DISEASE; DRUG MONITORING; HEALTH CARE COST; HUMAN; INFORMATION SYSTEM; INTRAVENOUS DRUG ADMINISTRATION; LOCAL ANESTHESIA; MEDICAL DECISION MAKING; PATIENT CARE; PHYSICIAN; PREVENTIVE MEDICINE; PRIORITY JOURNAL; REVIEW; TREATMENT OUTCOME;

EID: 0032556178     PISSN: 00987484     EISSN: None     Source Type: Journal    
DOI: 10.1001/jama.280.15.1339     Document Type: Review

References (91)

1. Clayton PD, Hripcsak G. Decision support in health care. Int J Biomed Comput. 1995;39:59-66.
2. Austin SM, Balas EA, Mitchell JA, Ewigman BG. Effect of physician reminders on preventive care: meta-analysis of randomized clinical trials. Proc Annu Symp Comput Appl Med Care. 1994:121-124.
3. Johnston ME, Langton KB, Haynes RB, Mathieu A. Effects of computer-based clinical decision support systems on clinician performance and patient outcome: a critical appraisal of research. Ann Intern Med. 1994;120:135-142.
4. Wyatt JC, Spiegelhalter DJ. Evaluating medical expert systems: what to test and how? Med Inf (Lond). 1990;15:205-217.
5. Haynes RB, Walker CJ. Computer-aided quality assurance: a critical appraisal. Arch Intern Med. 1987;147:1297-1301.
6. The Cochrane Library. Update Software. Issue 2. Oxford, England: Cochrane Library; 1998.
7. McDonald CJ, Hui SL, Zhou XH. Analyzing computer-based decision support systems. Ann Intern Med. 1994;121:469.
8. Cohen J. Statistical Power Analysis for the Behavioural Sciences. Hillsdale, NJ: Lawrence Erlbaum Publisher; 1988.
9. Gonzalez E, Vanderheyden BA, Ornato JP, Comstock TG. Computer-assisted optimization of aminophylline therapy in the emergency department. Am J Emerg Med. 1989;7:395-401.
10. Rodman JH, Jeliffe RW, Kolb E, et al. Clinical studies with computer-assisted initial lidocaine therapy. Arch Intern Med. 1984;144:703-709.
11. White RH, Hong R, Venook AP, et al. Initiation of warfarin therapy: comparison of physician dosing with computer-assisted dosing. J Gen Intern Med. 1987;2:141-148.
12. White RH, Mungall D. Outpatient management of warfarin therapy: comparison of computer-predicted dosage adjustment to skilled professional care. Ther Drug Monit. 1991;13:46-50.
13. Chase CR, Vacek PM, Shinozaki T, Giard AM, Ashikaga T. Medical information management: improving the transfer of research results to presurgical evaluation. Med Care. 1983;21:410-424.
14. Pozen MW, D'Agostino RB, Selker HP, Sytkowski PA, Hood WB. A predictive instrument to improve coronary-care-unit admission practices in acute ischemic heart disease: a prospective multicenter clinical trial. N Engl J Med. 1984;310:1273-1278.
15. Wellwood J, Johannessen S, Spiegelhalter DJ. How does computer-aided diagnosis improve the management of acute abdominal pain? Ann R Coll Surg Engl. 1992;74:40-46.
16. Wexler JR, Swender PT, Tunnessen WW, Oski FA. Impact of a system of computer-assisted diagnosis: initial evaluation of the hospitalized patient. AJDC. 1975;129:203-205.
17. Wyatt JR. Lessons learnt from the field trial of ACORN, an expert system to advise on chest pain. In: Proceedings of the Sixth World Conference on Medical Informatics; Singapore; 1989:111-115.
18. Barnett GO, Winickoff RN, Morgan MM, Zielstorff RD. A computer-based monitoring system for follow-up of elevated blood pressure. Med Care. 1983;21:400-409.
19. McDowell I, Newell C, Rosser W. Comparison of three methods of recalling patients for influenza vaccination. CMAJ. 1986;135:991-997.
20. McDowell I, Newell C, Rosser W. Computerized reminders to encourage cervical screening in family practice. J Fam Pract. 1989;28:420-424.
21. McDowell I, Newell C, Rosser W. A randomized trial of computerized reminders for blood pressure screening in primary care. Med Care. 1989;27:297-305.
22. Rosser WW, Hutchison BG, McDowell I, Newell C. Use of reminders to increase compliance with tetanus booster vaccination. CMAJ. 1992;146:911-917.
23. Tierney WM, Hui SL, McDonald CJ. Delayed feedback of physician performance versus immediate reminders to perform preventive care: effects on physician compliance. Med Care. 1986;24:659-666.
24. Brownbridge G, Evans A, Fitter M, Platts M. An interactive computerized protocol for the management of hypertension: effects on the general practitioner's clinical behaviour. J R Coll Gen Pract. 1986;36:198-202.
25. Coe FL, Norton E, Oparil S, Tatar A, Pullman TN. Treatment of hypertension by computer and physician - a prospective controlled study. J Chronic Dis. 1977;30:81-92.
26. Keller LS, McDermott S, Alt-White A. Effects of computerized nurse care planning on selected health care effectiveness measures. Proc Annu Symp Comput Appl Med Care. 1991;15:38-42.
27. McAlister NH, Covvy HD, Tong C, Lee A, Wigle ED. Randomized controlled trial of computer assisted management of hypertension in primary care. BMJ. 1986;293:670-674.
28. McDonald CJ. Use of a computer to detect and respond to clinical events: its effect on clinician behavior. Ann Intern Med. 1976;84:162-167.
29. McDonald CJ. Protocol-based computer reminders, the quality of care and the non-perfectability of man. N Engl J Med. 1976;295:1351-1355.
30. McDonald CJ, Wilson GA, McCabe GP. Physician response to computer reminders. JAMA. 1980; 244:1579-1587.
31. McDonald CJ, Hui SL, Smith DM, et al. Reminders to physicians from an introspective computer medical record. Ann Intern Med. 1984;100:130-138.
32. McDonald CJ, Hui SL, Tierney WM. Effects of computer reminders for influenza vaccination on morbidity during influenza epidemics. MD Comput. 1992;9:304-312.
33. Petrucci K, Petrucci P, Canfield K, et al. Evaluation of UNIS: urological nursing information systems. Proc Annu Symp Comput Appl Med Care. 1991;15:43-47.
34. Rogers JL, Haring OM. The impact of computerized medical record summary system on incidence and length of hospitalization. Med Care. 1979;17:618-630.
35. Rogers JL, Haring OM, Wortman PM. Medical information systems: assessing impact in the areas of hypertension, obesity and renal disease. Med Care. 1982;20:63-74.
36. Rogers JL, Haring OM, Goetz JP. Changes in patient attitudes following the implemenation of a medical information system. Q Rev Bull. 1984;10: 65-74.
37. Tierney WM, McDonald CJ, Hui SL, Martin DK. Computer predictions of abnormal test results: effects on outpatient testing. JAMA. 1988;259:1194-1198.
38. White KS, Lindsay A, Pryor TA, Brown WF, Walsh K. Application of a computerized medical decision-making process to the problem of digoxin intoxication. J Am Coll Cardiol. 1984;4:571-576.
39. Young DW. Improving the consistency with which investigations are requested. Med Inf(Lond). 1981;6:13-17.
40. Abbrecht PH, O'Leary TJ, Behrendt DM. Evaluation of a computer-assisted method for individualized anticoagulation: retrospective and prospective studies with a pharmacodynamic model. Clin Pharmacol Ther. 1982;32:129-136.
41. Begg EJ, Atkinson HC, Jeffery GM, Taylor NW. Individualised aminoglycoside dosage based on pharmacokinetic analysis is superior to dosage based on physician intuition at achieving target plasma drug concentrations. Br J Clin Pharmacol. 1989;28:137-141.
42. Carter BL, Taylor JW, Becker A. Evaluation of three dosage-prediction methods for initial in-hospital stabilization of warfarin therapy. Clin Pharm. 1987;6:37-45.
43. Casner PR, Reilly R, Ho H. A randomized controlled trial of computerized pharmacokinetic theophylline dosing versus empiric physician dosing. Clin Pharmacol Ther. 1993;53:684-690.
44. Hickling K, Begg EJ, Moore ML. A prospective randomised trial comparing individualised pharmacokinetic dosage prediction for amnioglycosides with prediction based on estimated creatinine clearance in critically ill patients. Intensive Care Med. 1989;15:233-237.
45. Hurley SF, Dziukas LJ, McNeil JJ, Brignell MJ. A randomized controlled clinical trial of pharmacokinetic theophylline dosing. Am Rev Respir Dis. 1986;134:1219-1224.
46. Mungall D, Anbe D, Forrester PL, et al. Clinic trials and therapeutics: a prospective randomized comparison of the accuracy of computer-assisted versus GUSTO nomogram - directed heparin therapy. Clin Pharmacol Ther. 1994;55:591-596.
47. Poller L, Wright D, Rowlands M. Prospective comparative study of computer programs used for management of warfarin. J Clin Pathol. 1993;46: 299-303.
48. Vadher B, Patterson DLH, Leaning M. Evaluation of a decision support system for initiation and control of oral anticoagulation in a randomised trial. BMJ. 1997;314:1252-1256.
49. Vadher BD, Patterson DLH, Leaning M. Comparison of oral anticoagulant control by a nurse-practitioner using a computer decision-support system with that by clinicians. Clin Lab Haematol. 1997;19:203-207.
50. Verner D, Seligmann H, Platt S. Computer assisted design of a theophylline dosing regimen in acute bronchospasm: serum concentrations and clinical outcome. Eur J Clin Pharmacol. 1992;43: 29-33.
51. Burack RC, Gimotty PA, George J, et al. Promoting screening mammography in inner-city settings: a randomized controlled trial of computerized reminders as a component of a program to facilitate mammography. Med Care. 1994;32:609-624.
52. Burack RC, Gimotty PA. George J, et al. The effect of patient and physician reminders on use of screening mammography in a health maintenance organization: results of a randomized controlled trial. Cancer. 1996;78:1708-1721.
53. Burack RC, Gimotty PA. Promoting screening mammography in inner-city settings: the sustained effectiveness of computerized reminders in a randomized controlled trial. Med Care. 1997;35:921-931.
54. Chambers CV, Balaban DJ, Carlson BL, Grasberger DM. The effect of microcomputer-generated reminders on influenza vaccination rates in a university-based family practice center. J Am Board Fam Pract. 1991;4:19-26.
55. Frame PS, Zimmer JG, Werth PL, Hall WJ, Eberly SW. Computer based vs manual health maintenence tracking: a controlled trial. Arch Fam Med. 1994;3:581-588.
56. McPhee SJ, Adair Bird J, Jenkins CN, Fordham D. Promoting cancer screening: a randomized, controlled trial of three interventions. Arch Intern Med. 1989;149:1866-1872.
57. McPhee SJ, Adair Bird J, Fordham D, Rodnick JE, Osborn EH. Promoting cancer prevention activities by primary care physicians: results of a randomized controlled trial. JAMA. 1991;266:538-544.
58. Ornstein SM, Garr DR, Jenkins RG, Rust PF, Arnon A. Computer-generated physician and patient reminders: tools to improve population adherence to selected preventive services. J Fam Pract. 1991;32:82-90.
59. Overhage JM, Tierney WM, McDonald CJ. Computer reminders to implement preventive care guidelines for hospitalized patients. Arch Intern Med. 1996;156:1551-1556.
60. Rosser WW, McDowell I, Newell C. Use of reminders for preventive procedures in family medicine. CMAJ. 1991;145:807-812.
61. Tape TG, Campbell JR. Computerized medical records and preventive health care: success depends on many factors. Am J Med. 1993;94:619-625.
62. Turner RC, Peden JG, O'Brien K. Patient-carried card prompts vs computer-generated prompts to remind private practice physicians to perform health maintenance measures. Arch Intern Med. 1994;154:1957-1960.
63. Turner BJ, Day SC, Borenstein B. A controlled trial to improve delivery of preventive care: physician or patient reminders. J Gen Intern Med. 1989; 4:403-409.
64. Bates DW, Kuperman GJ, Rittenberg E, et al. Reminders for redundant tests: results of a randomized controlled trial [abstract]. Proc Annu Symp Comput Appl Med Care. 1995:935.
65. Dexter PR, Wolinsky FD, Gramelspacher GP, et al. Effectiveness of computer-generated reminders for increasing discussions about advance directives and completion of advance directive forms: a randomized, controlled trial. Ann Intern Med. 1998; 128:102-110.
66. Fihn SD, McDonell MB, Vermes D, et al. A computerized intervention to improve timing of outpatient follow-up: a multicenter randomized trial in patients treated with warfarin. J Gen Intern Med. 1994;9:131-139.
67. Hales JW, Gardner RM, Jacobson JT. Factors impacting the success of computerized preadmission screening. Proc Annu Symp Comput Appl Med Care. 1995:728-732.
68. Lobach DF, Hammond WE. Development and evaluation of a computer-assisted management protocol (CAMP): improved compliance with care guidelines for diabetes mellitus. Proc Annu Symp Comput Appl Med Care. 1994:787-791.
69. Mazzuca SA, Vinicor F, Einterz RM, Norton JA, Kalasinski LA. Effects of the clinical environment on physicians' response to postgraduate medical education. Am Educ. Res J. 1990;27:473-488.
70. Nilasena DS, Lincoln MJ. A computer-generated reminder system improves physician compliance with diabetes preventive care guidelines. Proc Annu Symp Comput Appl Med Care. 1995:640-645.
71. Overhage JM, Tierney WM, Zhou XA, McDonald CJ. A randomized trial of "corollary orders" to prevent errors of omission. J Am Med Inform Assoc. 1997;4:364-375.
72. Rossi RA, Every NR. A computerized intervention to decrease the use of calcium channel blockers in hypertension. J Gen Intern Med. 1997;12:672-678.
73. Rotman BL, Sullivan AN, McDonald TW, et al. A randomized controlled trial of a computer-based physician workstation in an outpatient setting: implementation barriers to outcome evaluation. J Am Med Inform Assoc. 1996;3:340-348.
74. Rubenstein LV, McCoyJM, Cope DW. Improving patient quality of life with feedback to physicians about functional status. J Gen Intern Med. 1995;10:607-614.
75. Ryff-de-Leche A, Engler H, Nutzi E, Berger M, Berger W. Clinical application of two computerized diabetes management systems: comparison with the log-book method. Diabetes Res. 1992;19:97-105.
76. Safran C, Rind DM, Davis R, et al. Guidelines for management of HIV infection with computer-based patient's record. Lancet. 1995;346:341-346.
77. Shea S, Sideli RV, DuMouchel W, et al. Computer-generated informational messages directed to physicians: effect on length of hospital stay. J Am Med Inform Assoc. 1995;2:58-64.
78. Thomas JC, Moore A, Qualls PE. The effect on cost of medical care for patients treated with an automated clinical audit system. J Med Syst. 1983; 7:307-313.
79. Tierney WM, Miller ME, Overhage M, McDonald CJ. Physician inpatient order writing on microcomputer workstations: effects on resource utilization. JAMA. 1993;269:379-383.
80. Sheiner LB, Halkin H, Peck C, Rosenberg B, Melmon KL. Improved computer-assisted digoxin therapy: a method using feedback of measured serum digoxin concentrations. Ann Intern Med. 1975; 82:619-627.
81. Fitzmaurice DA, Hobbs FDR, Murray ET, Bradley CP, Holder R. Evaluation of computerized decision support for oral anticoagulation management based in primary care. Br J Gen Pract. 1996; 46:533-535.
82. Pringle M, Robins S, Brown G. Computer assisted screening: effects on the patient and his consultation. BMJ. 1990;290:1709-1712.
83. Hobbs FD, Delaney BC, Carson A, Kenkre JE. A prospective controlled trial of computerized decision support forlipid management in primary care. Fam Pract. 1996;13:133-137.
84. Destache CJ, Meyer SK, Bittner MJ, Hermann KG. Impact of a clinical pharmacokinetic service on patients treated with aminoglycosides: a cost-benefit analysis. Ther Drug Monit. 1990;12:419-426.
85. Dasta JF, Greer ML, Speedie SM. Computers in healthcare: overview and bibliography. Ann Pharmacother. 1992;26:109-117.
86. Miller RA. Medical diagnostic decision support systems - past, present, and future. J Am Med Inform Assoc. 1994;1:8-27.
87. McPhee SJ, Detmer WM. Office-based interventions to improve delivery of cancer prevention services by primary care physicians. Cancer. 1993; 72:1100-1112.
88. Balas EA, Austin SM, Mitchell JA, et al. The clinical value of computerized information services: a review of 98 randomized clinical trials. Arch Fam Med. 1996;5:271-278.
89. Shea S, DuMouchel W, Bahamonde L. A metaanalysis of 16 randomized controlled trials to evaluate computer-based reminder systems for preventive care in the ambulatory setting. J Am Med Inform Assoc. 1996;3:399-409.
90. Litzelman DK, Dittus RS, Miller ME, Tierney WM. Requiring physicians to respond to computerized reminders improves their compliance with preventive care protocols. J Gen Intern Med. 1993;8: 311-317.
91. Lobach DF. Electronically distributed, computer-generated, individualized feedback enhances the use of a computerized practice guideline. Proc AMIA Annu Fall Symp. 1996:493-497.