Review of Computerized Clinical Decision Support Systems for Drug Management
Author Information
Author(s): Brian J Hemens, Anne Holbrook, Marita Tonkin, Jean A Mackay, Lorraine Weise-Kelly, Tamara Navarro, Nancy L Wilczynski, Brian Haynes
Primary Institution: McMaster University
Hypothesis
Do CCDSSs improve performance on drug-related process of care measures or patient outcomes compared to usual care?
Conclusion
CCDSSs inconsistently improved process of care measures and seldom improved patient outcomes.
Supporting Evidence
- Sixty-five studies met our inclusion criteria, including 41 new studies since our previous review.
- CCDSSs improved process of care performance in 37 of the 59 studies assessing this type of outcome (64%).
- Twenty-nine trials assessed patient outcomes, of which six trials (21%) reported improvements.
Takeaway
This study looked at computer systems that help doctors make better decisions about medications. Sometimes they worked well, but often they didn't help patients feel better.
Methodology
A systematic review of randomized controlled trials assessing the effects of CCDSSs on process of care and patient outcomes.
Potential Biases
Potential bias due to incomplete data in many studies and limited power for multivariate analysis.
Limitations
Lack of clear patient benefit and lack of data on harms and costs preclude a recommendation to adopt CCDSSs for drug therapy management.
Participant Demographics
The studies included a total studied population of 1,246,686 patients, with a median of 2027 patients per study.
Statistical Information
Confidence Interval
95% confidence interval [CI], 0.91 to 0.94
Statistical Significance
p<0.05
Digital Object Identifier (DOI)
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