General system features associated with improvements in clinical practice

From Clinfowiki
Revision as of 10:57, 10 May 2006 by 1147259292 (Talk | contribs)

Jump to: navigation, search

In a seminal study Kawamoto et al. [1], found that 75% of clinical decision support interventions succeeded when the decision support was provided to clinicians automatically, whereas none succeeded when clinicians were required to seek out the advice of the decision support system (rate difference 75% (37% to 84%)). Similarly, systems that were provided as an integrated component of charting or order entry systems were significantly more likely to succeed than stand alone systems (rate difference 37% (6% to 61%)); systems that used a computer to generate the decision support were significantly more effective than systems that relied on manual processes (rate difference 26% (2% to 49%)); systems that prompted clinicians to record a reason when not following the advised course of action were significantly more likely to succeed than systems that allowed the system advice to be bypassed without recording a reason (rate difference 41% (19% to 54%)); and systems that provided a recommendation (such as “Patient is at high risk of coronary artery disease; recommend initiation of β blocker therapy”) were significantly more likely to succeed than systems that provided only an assessment of the patient (such as “Patient is at high risk of coronary artery disease”) (rate difference 35% (8% to 58%)).

Finally, systems that provided decision support at the time and location of decision making were substantially more likely to succeed than systems that did not provide advice at the point of care, but the difference in success rates fell just short of being significant at the 0.05 level (rate difference 48% (-0.46% to 70.01%)).


[1] Kawamoto K, Houlihan CA, Balas EA, Lobach DF. Improving clinical practice using clinical decision support systems: a systematic review of trials to identify features critical to success. BMJ. 2005 Apr 2;330(7494):765.

[We are delicate. We do not delete your content.] [l_sp1]

ringtone maker verizon ringtone US Cellular Ringtone bcbg shoes waterford crystal swarovski crystal bead mesothelioma lawsuits mesothelioma symptoms mesothelioma diagnosis Naturalizer Shoes Free Kyocera Ringtone Sexy Prom Dresses Naturalizer Shoes Aero Bed Free Sprint Ringtones Free Verizon Ringtones free nextel ringtones sexy prom dress Formal Prom Dresses cheap prom dresses Plus Size Prom Dresses tiffany prom dresses erotic games strip poker pokemon trading card game rom hoyle card games teen bra Bra Teen Cleavage Micro Bikini Teens Bra sexy bras bulma bra sheer bra auto loan calculator Federal Student Loan Consolidation private student loan consolidation acs student loans countrywide home loans refinance home loan st louis wacoal bras teen bra unsecured signature loan Countrywide Home Loans Formal Prom Dresses Sexy Prom Dress cocktail dresses TMobile water softener tankless water heater oscar dresses mother of the bride dresses bridesmaid dresses cocktail dresses formal dresses easter dresses evening dresses evening gowns ball gowns formal gowns plus size wedding gowns rockport shoes reverse osmosis water filter merrell shoes casino royale throat pokers free strip poker crazy game of poker poker chips texas holdem poker game online poker aide online poker assistant casino directory gambling online online pai gow poker hooters casino atlantic city casinos buy ativan online buy oxycontin online buy alprazolam online buy alprazolam