Improving Chronic Disease Management with Computerized Decision Support Systems
Author Information
Author(s): Roshanov Pavel S, Misra Shikha, Gerstein Hertzel C, Garg Amit X, Sebaldt Rolf J, Mackay Jean A, Weise-Kelly Lorraine, Navarro Tamara, Wilczynski Nancy L, Haynes R Brian
Primary Institution: McMaster University
Hypothesis
Do computerized clinical decision support systems (CCDSSs) improve chronic disease management processes or patient outcomes?
Conclusion
A small majority of CCDSSs improved care processes in chronic disease management and some improved patient health.
Supporting Evidence
- 87% of included trials measured system impact on the process of care.
- 52% of those demonstrated statistically significant improvements.
- 65% of trials measured impact on non-major patient outcomes.
- 31% of those demonstrated benefits.
Takeaway
Using computer systems to help doctors manage chronic diseases can make care better, but not always for patients' health.
Methodology
A systematic review of randomized controlled trials comparing CCDSSs to usual practice or non-CCDSS controls.
Potential Biases
Many studies were conducted by developers of the systems, raising concerns about publication bias.
Limitations
The evidence of CCDSS effectiveness is limited, especially regarding patient outcomes due to the small number and size of studies.
Participant Demographics
The trials included a total of 7,335 practitioners caring for 381,562 patients across various clinics.
Statistical Information
P-Value
p<0.05
Confidence Interval
95% CI, 0.91 to 0.94
Statistical Significance
p<0.05
Digital Object Identifier (DOI)
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