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Steven Shea, William DuMouchel, Lisa Bahamonde, A Meta-analysis of 16 Randomized Controlled Trials to Evaluate Computer-Based Clinical Reminder Systems for Preventive Care in the Ambulatory Setting, Journal of the American Medical Informatics Association, Volume 3, Issue 6, Nov/Dec 1996, Pages 399–409, https://doi.org/10.1136/jamia.1996.97084513
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Abstract
Objective: Computer-based reminder systems have the potential to change physician and patient behaviors and to improve patient outcomes. We performed a meta-analysis of published randomized controlled trials to assess the overall effectiveness of computer-based reminder systems in ambulatory settings directed at preventive care.
Design: Meta-analysis.
Search Strategy: Searches of the Medline (1966–1994), Nursing and Allied Health (1982–1994), and Health Planning and Administration (1975–1994) databases identified 16 randomized, controlled trials of computer-based reminder systems in ambulatory settings.
Statistical Methods: A weighted mixed effects model regression analysis was used to estimate intervention effects for computer and manual reminder systems for six classes of preventive practices.
Main Outcome Measure: Adjusted odds ratio for preventive practices.
Results: Computer reminders improved preventive practices compared with the control condition for vaccinations (adjusted odds ratio [OR] 3.09; 95% confidence interval [CI] 2.39–4.00), breast cancer screening (OR 1.88; 95% CI 1.44–2.45), colorectal cancer screening (OR 2.25; 95% CI 1.74–2.91), and cardiovascular risk reduction (OR 2.01;95% CI 1.55–2.61) but not cervical cancer screening (OR 1.15; 95% CI 0.89–1.49) or other preventive care (OR 1.02; 95% CI 0.79–1.32). For all six classes of preventive practices combined the adjusted OR was 1.77 (95% CI 1.38–2.27).
Conclusion: Evidence from randomized controlled studies supports the effectiveness of data-driven computer-based reminder systems to improve prevention services in the ambulatory care setting.
Author notes
Supported by a grant from The Commonwealth Fund.