A meta-analysis of 16 randomized controlled trials to evaluate computer-based clinical reminder systems for preventive care in the ambulatory setting.

Author: Shea- S; DuMouchel- W & Bahamonde- L
Tags: ICT


OBJECTIVE: Computer-based reminder systems have the potential to change physician and patient behaviors and to improve patient outcomes. We performed a meta-analysis of published randomized controlled trials to assess the overall effectiveness of computer-based reminder systems in ambulatory settings directed at preventive care. DESIGN: Meta-analysis. SEARCH STRATEGY: Searches of the Medline (1966-1994)- Nursing and Allied Health (1982-1994)- and Health Planning and Administration (1975-1994) databases identified 16 randomized- controlled trials of computer-based reminder systems in ambulatory settings. STATISTICAL METHODS: A weighted mixed effects model regression analysis was used to estimate intervention effects for computer and manual reminder systems for six classes of preventive practices. MAIN OUTCOME MEASURE: Adjusted odds ratio for preventive practices. RESULTS: Computer reminders improved preventive practices compared with the control condition for vaccinations (adjusted odds ratio OR 3.09/ 95% confidence interval CI 2.39-4.00)- breast cancer screening (OR 1.88/ 95% CI 1.44-2.45)- colorectal cancer screening (OR 2.25/ 95% CI 1.74-2.91)- and cardiovascular risk reduction (OR 2.01/ 95% CI 1.55-2.61) but not cervical cancer screening (OR 1.15/ 95% CI 0.89-1.49) or other preventive care (OR 1.02/ 95% CI 0.79-1.32). For all six classes of preventive practices combined the adjusted OR was 1.77 (95% CI 1.38-2.27). CONCLUSION: Evidence from randomized controlled studies supports the effectiveness of data-driven computer-based reminder systems to improve prevention services in the ambulatory care setting.


Type Journal article
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Link http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=116324&tool=pmcentrez&rendertype=abstract
Journal Journal of the American Medical Informatics Association : JAMIA
Volume 3
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