This Article  • Full text  • PDF  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citation map  • Citing articles on HighWire  • Citing articles on Web of Science (47)  • Contact me when this article is cited  Related Content  • Related article  • Similar articles in JAMA  Social Bookmarking   What's this?

XVIII. How to Use an Article Evaluating the Clinical Impact of a Computer-Based Clinical Decision Support System

Adrienne G. Randolph, MD, MSc; R. Brian Haynes, MD, PhD; Jeremy C. Wyatt, MD; Deborah J. Cook, MD, MSc; Gordon H. Guyatt, MD, MSc

JAMA. 1999;282:67-74.

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

CLINICAL SCENARIO

It is 7 AM, and medical rounds are starting on university hospital ward 3B. In the past 24 hours of your residency, you have transferred 2 critically ill patients to the intensive care unit; accepted 11 patients to your medical service; examined and revised medication orders for 22 patients; placed 9 intravascular catheters; written 35 notes; and reviewed, categorized, and acted on more than 300 new pieces of laboratory and radiology data. You were planning to ask the infectious disease specialist about a patient, but he seems very busy, and the broad-spectrum antibiotic regimen you prescribed should suffice. You were just told that you ordered total parenteral nutrition for the wrong patient. While deciding which patient should receive parenteral nutrition, you realize that the calculations for . . . [Full Text of this Article]

THE SEARCH

CLINICAL COMPUTER SYSTEMS

Are the Results of the Study Valid?

Was the Method of Participant Allocation Appropriate?

Was the Control Group Uninfluenced by the CDSS?

Aside From the CDSS, Were the Groups Treated Equally?

What Are the Results?

What Is the Effect of the CDSS?

Can You Apply the CDSS in Your Clinical Setting?

What Elements of the CDSS Are Required?

Is the CDSS Exportable to a New Site?

Is the CDSS Likely to Be Accepted by Clinicians in Your Setting?

Do the Benefits of the CDSS Justify the Risks and Costs?

Are CDSSs Beneficial?

RESOLUTION OF THE SCENARIO

Author Affiliations: Departments of Pediatrics and Anesthesia, Children's Hospital and Harvard Medical School, Boston, Mass (Dr Randolph); Departments of Clinical Epidemiology and Biostatistics and Medicine, McMaster University, Hamilton, Ontario (Drs Haynes, Cook, and Guyatt); and School of Public Policy, University College London, London, England (Dr Wyatt).

CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter     What's this?

RELATED ARTICLE

July 7, 1999
JAMA. 1999;282(1):99-100.
EXTRACT | FULL TEXT  

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

An Electronic Health Record-Based Intervention to Improve Tobacco Treatment in Primary Care: A Cluster-Randomized Controlled Trial
Linder et al.
Arch Intern Med 2009;169:781-787.
ABSTRACT | FULL TEXT  

Effect of guideline based computerised decision support on decision making of multidisciplinary teams: cluster randomised trial in cardiac rehabilitation
Goud et al.
BMJ 2009;338:b1440-b1440.
ABSTRACT | FULL TEXT  

"Smart Forms" in an Electronic Medical Record: Documentation-based Clinical Decision Support to Improve Disease Management
Schnipper et al.
J. Am. Med. Inform. Assoc. 2008;15:513-523.
ABSTRACT | FULL TEXT  

Electronic Alerts Versus On-Demand Decision Support to Improve Dyslipidemia Treatment: A Cluster Randomized Controlled Trial
van Wyk et al.
Circulation 2008;117:371-378.
ABSTRACT | FULL TEXT  

Accreditation Council for Graduate Medical Education Competencies: Practice-Based Learning and Systems-Based Practice
Moskowitz and Nash
American Journal of Medical Quality 2007;22:351-382.
 

Searching for Evidence-Based Medicine in the Literature Part 3: Assessment
Bartkowiak
Clin Med Res 2005;3:113-115.
FULL TEXT  

What makes a good clinical decision support system
Purcell
BMJ 2005;330:740-741.
FULL TEXT  

Effect of computerised evidence based guidelines
Emery et al.
BMJ 2003;326:394-394.
FULL TEXT  

Cluster-randomized, controlled trial of computer-based decision support for selecting long-term anti-thrombotic therapy after acute ischaemic stroke
QJM 2003;96:143-153.
ABSTRACT | FULL TEXT  

Evidence-based Radiology: A New Approach to the Practice of Radiology
The Evidence-Based Radiology Working Group
Radiology 2001;220:566-575.
ABSTRACT | FULL TEXT  

Evidence-Based Medicine in Anesthesiology
Pronovost et al.
Anesth. Analg. 2001;92:787-794.
FULL TEXT  

Erythropoietin: A Paradigm for the Development of Practice Guidelines
Rizzo et al.
ASH Education Book 2001;2001:10-30.
ABSTRACT | FULL TEXT  

Evidence for the Effectiveness of Techniques To Change Physician Behavior
Smith
Chest 2000;118 :8S-17S.
ABSTRACT | FULL TEXT  

A Clinical Decision Support System for Prevention of Venous Thromboembolism: Effect on Physician Behavior
Durieux et al.
JAMA 2000;283:2816-2821.
ABSTRACT | FULL TEXT  

A Guideline Implementation System Using Handheld Computers for Office Management of Asthma: Effects on Adherence and Patient Outcomes
Shiffman et al.
Pediatrics 2000;105:767-773.
ABSTRACT | FULL TEXT  

Evaluation of computer based clinical decision support system and risk chart for management of hypertension in primary care: randomised controlled trial
Montgomery et al.
BMJ 2000;320:686-690.
ABSTRACT | FULL TEXT  

Clinical Decision-support Systems:: Evaluating the Evaluation
Hornberger and Kane Goldstein
Med Decis Making 2000;20:130-131.
 

Can computerised decision support systems deliver improved quality in primary care?
Delaney et al.
BMJ 1999;319:1281-1281.
FULL TEXT