Background
Methods
Selection criteria
Search strategy
Review process
Results
Excluded studies
Included studies
Setting and participants
Intervention
Outcome
Risk of bias in included studies
Effects of intervention
Study | Risk of bias | No of patients/professionals | Intervention | Outcomes | |
---|---|---|---|---|---|
Process | Patient | ||||
Christakis[21] Cluster-RCT | low | 1,339 visits for OM, 38 physicians | Evidence-based (EB) message system presenting real time evidence to providers based on their prescribing practice for otitis media (OM). | Y | |
Davis[10] Cluster-RCT | low | 12,195 visits, 44 healthcare providers | EB message system that presented real-time evidence to providers based on prescribing practices for acute otitis media, allergic rhinitis, sinusitis, constipation, pharyngitis, croup, urticaria, and bronchiolitis | Y | |
Meigs[12] Cluster-RCT | moderate | 598 patients, 66 healthcare providers | Diabetes management application, (DMA); interactive patient-specific clinical data, treatment advice, and links to other web-based resources | N | N |
Montgomery[26] Cluster-RCT | moderate | 614 patients, 27 general practices | Computer-based clinical decision support system and a risk chart on absolute cardiovascular risk, blood pressure, and prescribing of cardiovascular drugs in hypertensive patients. | N | N |
Rollman[13] Cluster-RCT | moderate | 200 patients, 17 primary care physicians | Guideline-based treatment advice for depression Active care Passive care | N N | N N |
van Wyk[32] Cluster-RCT | moderate | 87,866 patients, 77 primary care physicians | Clinical decision support system with respect to screening and treatment of dyslipidemia Alerting version On-demand version | Y N | |
Carton[36] ITS design | high | 6,869 radiological examinations in sample | Reminder on screen, indicating the appropriate recommendations concerning radiology requests | N | |
Day[18] ITS design | high | off: 103 patients on: 258 patients off: 125 patients | Real-time advice regarding documentation, testing, treatment and disposition of emergency department patients with low back pain (EDECS) | N | |
Hetlevik '99[34] Cluster-RCT | high | 2,230 patients, 53 physicians | Clinical decision support system for hypertension | N | |
Hetlevik '00[35] Cluster-RCT | high | 1,034 patients, 53 physicians | Clinical decision support system for diabetes mellitus | N | |
Hicks[22] Cluster-RCT | high | 2,027 patients, 14 primary care practices | Electronic decision support for hypertensive patients | Y | N |
McCowan[25] Cluster-RCT | high | 477 patients, 17 practices | Computerized decision support system for the management of asthma | N | N |
Poley[29] CBA design | high | 109 primary care physicians | Guideline-driven decision-support system for ordering blood tests in primary care | N | |
Safran[23] CCT | high | 349 patients in analysis, 126 physicians and nurses | Reminders and alerts for HIV infection | Y | N |
Schriger '97[19] ITS design | high | off: 50 patients on: 156 patients off: 74 patients | Real-time advice regarding documentation, testing, treatment and disposition of emergency department patients regarding the management of body fluid exposure (EDECS) | Y | |
Schriger '00[20] ITS design | high | off: 352 patients on: 374 patients off: 104 patients | Real-time advice regarding documentation, testing and treatment of children with fever presenting in the emergency department (EDECS) | N | |
Sequist[14] Cluster-RCT | high | Diabetes: 4,549 patients - CAD: 2,199 patients, 194 physicians | EB electronic reminders for diabetes and coronary artery disease (CAD) | N | |
Szpunar[11] CBA design | high | Pre: 5,334 patients - Post: 3,970 patients, 6 clinics | Tobacco Use Cessation (TUC) Automated Clinical Practice Guideline | Y | |
Martens[33] Cluster-RCT | high | 53 primary care physicians | Intervention group one: Reminders on antibiotics, asthma/chronic obstructive pulmonary disease (COPD) Intervention group two: Reminders on cholesterol-lowering drugs | N |
Study | Risk of bias | No of patients/professionals | Intervention | Outcomes | |
---|---|---|---|---|---|
Process | Patient | ||||
Eccles[24] Cluster-RCT | low | 2,400 patients, 60 primary care practices | Intervention group one: Computerized asthma guidelines + paper version of the guidelines for asthma and angina Intervention group two: Computerized angina guidelines + paper version of the guidelines for asthma and angina | N | |
Tierney '03[15] Cluster-RCT | low | 706 patients, 246 physicians | Intervention group one: Computerized cardiac care suggestions + printed summary of the guidelines Intervention group two and three: not included in analysis of this review Control group: Usual care + printed summary of the guidelines | N | N |
Tierney '05[16] Cluster-RCT | low | 706 patients, 246 physicians | Intervention group one: Computerized feedback for asthma and COPD + printed summary of the guidelines Intervention group two and three: not included in analysis of this review Control group: Usual care + printed summary of the guidelines | N | N |
Jousimaa[37] Cluster-RCT | moderate | 2,813 evaluated cases, 130 physicians | Intervention group: CD ROM of primary care guidelines Control group: Text based version of primary care guidelines | N | |
Montgomery[26] Cluster-RCT | moderate | 614 patients, 27 primary care practices | Intervention group: Computer-based clinical decision support system and a risk chart on absolute cardiovascular risk, blood pressure, and prescribing of cardiovascular drugs in hypertensive patients. Control group: Cardiovascular risk chart on paper alone | N | N |
Murray[17] Cluster-RCT | moderate | 712 patients, 246 physicians | Intervention group one: Computerized suggestions for hypertension + printed, referenced summary of the locally approved guidelines Intervention group two and three: not included in analysis of this review Control group: Usual care + printed, referenced summary of the locally approved guidelines | N | N |
Wilson[27] Cluster-RCT | moderate | 86 practices | Intervention group: Electronic referral guidelines for breast cancer + mailed referral guidelines Control group: Usual care + mailed referral guidelines | N | N |
Kuilboer[30] Cluster-RCT | high | 156,772 patients, 40 primary care physicians | Intervention group: AsthmaCritic provides patient-specific feedback for asthma and COPD + disposal of the asthma and COPD guidelines Control group: Usual care + disposal of the asthma and COPD guideline | N |
Study | Risk of bias | No or patients/professionals | Intervention | Outcomes | |
---|---|---|---|---|---|
Process | Patient | ||||
Van Wijk[31] Cluster-RCT | low | 7,094 patients, 44 primary care practices | Intervention group one: BloodLink Guideline Intervention group two: BloodLink Restricted | Y | |
In favour of BloodLink Guideline | |||||
Rollman[13] Cluster-RCT | moderate | 200 patients, 17 primary care physicians | Intervention group one: Guideline-based treatment advice for depression: active care Intervention group two: Guideline-based treatment advice for depression: passive care | N | N |
Van Wyk[32] Cluster-RCT | moderate | 87,866 patients, 77 primary care physicians | Intervention group one: Clinical decision support system with respect to screening and treatment of dyslipidemia: alerting version Intervention group two: Clinical decision support system with respect to screening and treatment of dyslipidemia: on-demand version | Y | |
In favour of the alerting version |