Results were inconsistent for changes in CVD risk factors such as systolic and diastolic blood pressure , total and low-density lipoprotein cholesterol , and hemoglobin A1C levels .
CONCLUSIONS CDSSs are effective in improving clinician practice s related to screening and other preventive care services , clinical tests , and treatments .
CONTEXT Clinical decision support systems ( CDSSs ) can help clinicians assess cardiovascular disease ( CVD ) risk and manage CVD risk factors by providing tailored assessment s and treatment recommendations based on individual patient data .
The goal of this systematic review was to examine the effectiveness of CDSSs in improving screening for CVD risk factors , practice s for CVD-related preventive care services such as clinical tests and prescribed treatments , and management of CVD risk factors .
A controlled time-series trial of clinical reminders: using computerized firm systems to make quality improvement research a routine part of mainstream practice.
OBJECTIVE To explore the feasibility of conducting unobtrusive interventional research in community practice setting s by integrating firm-system techniques with time-series analysis of relational-repository data . STUDY SETTING A satellite teaching clinic divided into two similar , but geographically separated , primary care group practice s called firms . One firm was selected by chance to receive the study intervention . Forty-two providers and 2,655 patients participated . STUDY DESIGN A nonr and omized controlled trial of computer-generated preventive reminders . Net effects were determined by quantitatively combining population -level data from parallel experimental and control interrupted time series extending over two-month baseline and intervention periods . DATA COLLECTION Mean rates at which mammography , colorectal cancer screening , and cholesterol testing were performed on patients due to receive each maneuver at clinic visits were the trial 's outcome measures . PRINCIPAL FINDINGS Mammography performance increased on the experimental firm by 154 percent ( 0.24 versus 0.61 , p = .03 ) . No effect on fecal occult blood testing was observed . Cholesterol ordering decreased on both the experimental ( 0.18 versus 0.1 1 , p = .02 ) and control firms ( 0.13 versus 0.07 , p = .03 ) coincident with national guidelines retreating from recommending screening for young adults . A traditional uncontrolled interrupted time-series design would have incorrectly attributed the experimental-firm decrease to the introduction of reminders . The combined analysis properly indicated that no net prompting effect had occurred , as the difference between firms in cholesterol testing remained stochastically stable over time ( 0.05 versus 0.04 , p = .75 ) . A logistic-regression analysis applied to individual-level data produced equivalent findings . The trial incurred no supplementary data collection costs . CONCLUSIONS The apparent validity and practicability of our reminder implementation study should encourage others to develop computerized firm systems capable of conducting controlled time-series trials
Results were inconsistent for changes in CVD risk factors such as systolic and diastolic blood pressure , total and low-density lipoprotein cholesterol , and hemoglobin A1C levels .
CONCLUSIONS CDSSs are effective in improving clinician practice s related to screening and other preventive care services , clinical tests , and treatments .
CONTEXT Clinical decision support systems ( CDSSs ) can help clinicians assess cardiovascular disease ( CVD ) risk and manage CVD risk factors by providing tailored assessment s and treatment recommendations based on individual patient data .
The goal of this systematic review was to examine the effectiveness of CDSSs in improving screening for CVD risk factors , practice s for CVD-related preventive care services such as clinical tests and prescribed treatments , and management of CVD risk factors .