Can computerized clinical decision support systems improve diagnostic test ordering behavior?
Author Information
Author(s): Roshanov Pavel S, You John J, Dhaliwal Jasmine, Koff David, Mackay Jean A, Weise-Kelly Lorraine, Navarro Tamara, Wilczynski Nancy L, Brian Haynes R
Primary Institution: McMaster University
Hypothesis
Do CCDSSs improve practitioners' diagnostic test ordering behavior?
Conclusion
Some CCDSSs can modify practitioner test-ordering behavior.
Supporting Evidence
- Thirty-five studies were identified, with significantly higher methodological quality in those published after the year 2000.
- 55% of CCDSSs improved testing behavior overall.
- Four of the systems explicitly attempted to reduce test ordering rates and all succeeded.
Takeaway
This study looked at whether computer systems can help doctors order the right tests for their patients. It found that some of these systems do help doctors make better choices.
Methodology
A systematic review of randomized controlled trials comparing CCDSSs to usual practice in clinical care settings.
Potential Biases
Some studies were conducted by developers of the CCDSSs, which may introduce bias.
Limitations
The review did not evaluate effects on patient outcomes and many studies lacked detailed reporting on system design and implementation.
Participant Demographics
The trials included a total of 4,212 practitioners caring for 626,382 patients across 835 clinics.
Statistical Information
P-Value
0.002
Confidence Interval
95% CI, 0.91 to 0.94
Statistical Significance
p<0.05
Digital Object Identifier (DOI)
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