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A Meta-analysis of 16 Randomized Controlled Trials to Evaluate Computer-Based Clinical Reminder Systems for Preventive Care in the Ambulatory Setting
Open accessAbstract
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.
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Metadata
- Authors
- Shea, S., DuMouchel, W., & Bahamonde, L.
- Venue
- Journal of the American Medical Informatics Association
- Publisher
- Oxford University Press (OUP)
- Published
- 1996-11-01
- Volume
- 3
- Issue
- 6
- Pages
- 399-409
- ISSN
- 1067-5027 (ISSN-L)
- 1527-974X
- OpenAlex
- W2112808048
- Cited by
- 542
- References
- 2
- FWCI
- 2.92
- Type
- journal article
- Language
- en
- Open access
- bronze
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