Clinical decision support provided within physician order entry systems: a systematic review of features effective for changing clinician behavior.

@article{citeulike:349640, abstract = {Computerized physician order entry (CPOE) systems represent an important tool for providing clinical decision support. In undertaking this systematic review, our objective was to identify the features of CPOE-based clinical decision support systems (CDSSs) most effective at modifying clinician behavior. For this review, two independent reviewers systematically identified randomized controlled trials that evaluated the effectiveness of CPOE-based CDSSs in changing clinician behavior. Furthermore, each included study was assessed for the presence of 14 CDSS features. We screened 10,023 citations and included 11 studies. Of the 10 studies comparing a CPOE-based CDSS intervention against a non-CDSS control group, 7 reported a significant desired change in professional practice. Moreover, meta-regression analysis revealed that automatic provision of the decision support was strongly associated with improved professional practice (adjusted odds ratio, 23.72; 95\% confidence interval, 1.75-infiniti). Thus, we conclude that automatic provision of decision support is a critical feature of successful CPOE-based CDSS interventions.}, address = {Department of Community and Family Medicine, Duke University Medical Center, Durham, North Carolina, USA.}, author = {Kawamoto, K. and Lobach, D. F. }, citeulike-article-id = {349640}, journal = {AMIA Annu Symp Proc}, keywords = {behavior, cdss, physician}, pages = {361--365}, posted-at = {2005-11-21 22:52:50}, priority = {0}, title = {Clinical decision support provided within physician order entry systems: a systematic review of features effective for changing clinician behavior.}, url = {http://view.ncbi.nlm.nih.gov/pubmed/14728195}, year = {2003} }

TY - JOUR ID - citeulike:349640 L3 - citeulike-article-id:349640 TI - Clinical decision support provided within physician order entry systems: a systematic review of features effective for changing clinician behavior. JF - AMIA Annu Symp Proc SP - 361 EP - 365 AD - Department of Community and Family Medicine, Duke University Medical Center, Durham, North Carolina, USA. N2 - Computerized physician order entry (CPOE) systems represent an important tool for providing clinical decision support. In undertaking this systematic review, our objective was to identify the features of CPOE-based clinical decision support systems (CDSSs) most effective at modifying clinician behavior. For this review, two independent reviewers systematically identified randomized controlled trials that evaluated the effectiveness of CPOE-based CDSSs in changing clinician behavior. Furthermore, each included study was assessed for the presence of 14 CDSS features. We screened 10,023 citations and included 11 studies. Of the 10 studies comparing a CPOE-based CDSS intervention against a non-CDSS control group, 7 reported a significant desired change in professional practice. Moreover, meta-regression analysis revealed that automatic provision of the decision support was strongly associated with improved professional practice (adjusted odds ratio, 23.72; 95% confidence interval, 1.75-infiniti). Thus, we conclude that automatic provision of decision support is a critical feature of successful CPOE-based CDSS interventions. KW - behavior KW - cdss KW - physician AU - Kawamoto, K AU - Lobach, DF PY - 2003/// UR - http://view.ncbi.nlm.nih.gov/pubmed/14728195 ER -