We systematically reviewed randomized controlled trials (RCTs) assessing the effectiveness ofcomputerized decision support systems (CDSSs) featuring rule- or algorithm-based software integrated with electronic health records (EHRs) and evidence-based knowledge. We searched MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials, and Cochrane Database of Abstracts of Reviews of Effects. Information on system design, capabilities, acquisition, implementation context, and effects on mortality, morbidity, and economic outcomes were extracted. Twenty-eight RCTs were included. CDSS use did not affect mortality (16 trials, 37395 patients; 2282 deaths; risk ratio [RR] = 0.96; 95%confidence interval [CI] = 0.85, 1.08; I2 = 41%).Astatistically significant effect was evident in the prevention ofmorbidity, any disease (9 RCTs; 13868 patients;RR = 0.82; 95% CI = 0.68, 0.99; I2 = 64%), but selectiveoutcomereporting or publication bias cannot be excluded. We observed differences for costs and health service utilization, although these were often small in magnitude. Across clinical settings, new generation CDSSs integrated with EHRs do not affect mortality and might moderately improvemorbidity outcomes.

Effectiveness of computerized decision support systems linked to electronic health records : a systematic review and meta-analysis / L. Moja, K.H. Kwag, T. Lytras, L. Bertizzolo, L. Brandt, V. Pecoraro, G. Rigon, A. Vaona, F. Ruggiero, M. Mangia, A. Iorio, I. Kunnamo, S. Bonovas. - In: AMERICAN JOURNAL OF PUBLIC HEALTH. - ISSN 0090-0036. - 104:12(2014 Dec), pp. e12-e22. [10.2105/AJPH.2014.302164]

Effectiveness of computerized decision support systems linked to electronic health records : a systematic review and meta-analysis

L. Moja;L. Bertizzolo;V. Pecoraro;F. Ruggiero;S. Bonovas
2014-12

Abstract

We systematically reviewed randomized controlled trials (RCTs) assessing the effectiveness ofcomputerized decision support systems (CDSSs) featuring rule- or algorithm-based software integrated with electronic health records (EHRs) and evidence-based knowledge. We searched MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials, and Cochrane Database of Abstracts of Reviews of Effects. Information on system design, capabilities, acquisition, implementation context, and effects on mortality, morbidity, and economic outcomes were extracted. Twenty-eight RCTs were included. CDSS use did not affect mortality (16 trials, 37395 patients; 2282 deaths; risk ratio [RR] = 0.96; 95%confidence interval [CI] = 0.85, 1.08; I2 = 41%).Astatistically significant effect was evident in the prevention ofmorbidity, any disease (9 RCTs; 13868 patients;RR = 0.82; 95% CI = 0.68, 0.99; I2 = 64%), but selectiveoutcomereporting or publication bias cannot be excluded. We observed differences for costs and health service utilization, although these were often small in magnitude. Across clinical settings, new generation CDSSs integrated with EHRs do not affect mortality and might moderately improvemorbidity outcomes.
cluster-randomized-trial; implementing clinical guidelines; provider order entry; information-tecnology; cost-effectiveness; primary-care; diabetes care; patient outcomes; general-practice; management
Settore MED/42 - Igiene Generale e Applicata
Effect on professional practice and health care outcomes of computerized evidence-based information system and clinical decision support: a randoized controlled trial in orthopedics
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Utilizza questo identificativo per citare o creare un link a questo documento: http://hdl.handle.net/2434/272485
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