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

American journal of public health (1971), 2014-12, Vol.104 (12), p.e12-e22 [Peer Reviewed Journal]

Copyright American Public Health Association Dec 2014 ;American Public Health Association 2014 2014 ;ISSN: 0090-0036 ;EISSN: 1541-0048 ;DOI: 10.2105/AJPH.2014.302164 ;PMID: 25322302 ;CODEN: AJPHDS

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Title:
Effectiveness of computerized decision support systems linked to electronic health records: a systematic review and meta-analysis
Author: Moja, Lorenzo ; Kwag, Koren H ; Lytras, Theodore ; Bertizzolo, Lorenzo ; Brandt, Linn ; Pecoraro, Valentina ; Rigon, Giulio ; Vaona, Alberto ; Ruggiero, Francesca ; Mangia, Massimo ; Iorio, Alfonso ; Kunnamo, Ilkka ; Bonovas, Stefanos
Subjects: Algorithms ; Clinical trials ; Cost control ; Decision making ; Decision support systems ; Decision Support Techniques ; Diagnostic tests ; Electronic Health Records ; Health Administration ; Health care ; Health Care Facilities/Services ; Health Professionals ; Hospitals ; Humans ; Medical personnel ; Morbidity ; Mortality ; Mortality - trends ; Online Systematic Review ; Patients ; Performance evaluation ; Physicians ; Professionals ; Public health ; Quality Assurance, Health Care ; Quality of Care ; Randomized Controlled Trials as Topic ; Software ; Studies ; Systematic review
Is Part Of: American journal of public health (1971), 2014-12, Vol.104 (12), p.e12-e22
Description: We systematically reviewed randomized controlled trials (RCTs) assessing the effectiveness of computerized 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; I(2) = 41%). A statistically significant effect was evident in the prevention of morbidity, any disease (9 RCTs; 13868 patients; RR = 0.82; 95% CI = 0.68, 0.99; I(2) = 64%), but selective outcome reporting 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 improve morbidity outcomes.
Publisher: United States: American Public Health Association
Language: English
Identifier: ISSN: 0090-0036
EISSN: 1541-0048
DOI: 10.2105/AJPH.2014.302164
PMID: 25322302
CODEN: AJPHDS
Source: ProQuest One Psychology
MEDLINE
ProQuest Databases
PubMed Central

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

Copyright American Public Health Association Dec 2014 ;American Public Health Association 2014 2014 ;ISSN: 0090-0036 ;EISSN: 1541-0048 ;DOI: 10.2105/AJPH.2014.302164 ;PMID: 25322302 ;CODEN: AJPHDS

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