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Reminders to Physicians from an Introspective Computer Medical Record: A Two-Year Randomized Trial
Abstract
We developed a computer-stored medical record system containing a limited set of the total clinical data base--primarily diagnostic studies and treatments. This system responds to its own content according to physician-authored reminder rules. To determine the effect of the reminder messages generated by 1490 rules on physician behavior, we randomly assigned practitioners in a general medicine clinic to study or control groups. The computer found indications for six different actions per patient in 12 467 patients during a 2-year study: 61 study group residents who received computer reminders responded to 49% of these indications; 54 control group residents, to only 29% (p less than 0.0001). Preventive care (occult blood testing, mammographic screening, weight reduction diets, influenza and pneumococcal vaccines) was affected. The intentions of the study group to use a given action for an indication predicted their response to the indications (p less than 0.03, r2 = 0.33). The intentions of the control residents did not.
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Cited by
Chaudhry, B., Wang, J., Wu, S., Maglione, M., Mojica, W., Roth, E., Morton, S. C., & Shekelle, P. G. (2006) · Annals of Internal Medicine · doi:10.7326/0003-4819-144-10-200605160-00125 · Cited by 3,159
Garg, A. X., Adhikari, N. K. J., McDonald, H., Rosas-Arellano, M. P., Devereaux, P. J., Beyene, J., Sam, J., & Haynes, R. B. (2005) · JAMA · doi:10.1001/jama.293.10.1223 · Cited by 2,936
Effect of clinical guidelines on medical practice: a systematic review of rigorous evaluations
Grimshaw, J. M., & Russell, I. T. (1993) · The Lancet · doi:10.1016/0140-6736(93)92244-n · Cited by 2,770
Ash, J. S. (2003) · Journal of the American Medical Informatics Association · doi:10.1197/jamia.m1471 · Cited by 1,789
Managing Clinical Knowledge for Health Care Improvement
Balas, E. A., & Boren, S. A. (2000) · Yearbook of Medical Informatics · doi:10.1055/s-0038-1637943 · Cited by 1,479
Metadata
- Authors
- McDONALD, C. J., HUI, S. L., SMITH, D. M., TIERNEY, W. M., COHEN, S. J., WEINBERGER, M., & McCABE, G. P.
- Venue
- Annals of Internal Medicine
- Publisher
- American College of Physicians
- Published
- 1984-01-01
- Volume
- 100
- Issue
- 1
- Pages
- 130-138
- ISSN
- 0003-4819 (ISSN-L)
- 1539-3704
- OpenAlex
- W2070472909
- Cited by
- 625
- References
- 0
- FWCI
- 86.34
- Type
- journal article
- Language
- en
- Open access
- closed
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- The paper
- McDONALD, C. J., HUI, S. L., SMITH, D. M., TIERNEY, W. M., COHEN, S. J., WEINBERGER, M., & McCABE, G. P. (1984). Reminders to Physicians from an Introspective Computer Medical Record: A Two-Year Randomized Trial. Annals of Internal Medicine. https://doi.org/10.7326/0003-4819-100-1-130
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Bibliographic data: Semantic Scholar, OpenAlex, Crossref.
Contains information from the Semantic Scholar Academic Graph Datasets, made available under the ODC Attribution License (ODC-BY 1.0).
Semantic Scholar’s data is described in: Kinney, R., et al. (2023). The Semantic Scholar Open Data Platform. arXiv:2301.10140.
