Department of Public Health-Università Cattolica Sacro Cuore-Rome, Rome, Italy.
BMC Health Serv Res. 2010 Jan 4;10:2. doi: 10.1186/1472-6963-10-2.
Clinical practice guidelines have been developed aiming to improve the quality of care. The implementation of the computerized clinical guidelines (CCG) has been supported by the development of computerized clinical decision support systems.This systematic review assesses the impact of CCG on the process of care compared with non-computerized clinical guidelines.
Specific features of CCG were studied through an extensive search of scientific literature, querying electronic databases: Pubmed/Medline, Embase and Cochrane Controlled Trials Register. A multivariable logistic regression was carried out to evaluate the association of CCG's features with positive effect on the process of care.
Forty-five articles were selected. The logistic model showed that Automatic provision of recommendation in electronic version as part of clinician workflow (Odds Ratio [OR]= 17.5; 95% confidence interval [CI]: 1.6-193.7) and Publication Year (OR = 6.7; 95%CI: 1.3-34.3) were statistically significant predictors.
From the research that has been carried out, we can conclude that after implementation of CCG significant improvements in process of care are shown. Our findings also suggest clinicians, managers and other health care decision makers which features of CCG might improve the structure of computerized system.
临床实践指南的制定旨在提高医疗质量。计算机化临床指南（CCG）的实施得到了计算机化临床决策支持系统的支持。本系统评价评估了 CCG 与非计算机化临床指南相比对护理过程的影响。
通过广泛搜索科学文献，查询电子数据库：Pubmed/Medline、Embase 和 Cochrane 对照试验登记处，研究了 CCG 的具体特征。采用多变量逻辑回归评估 CCG 特征与护理过程积极影响之间的关联。
选择了 45 篇文章。逻辑模型显示，作为临床医生工作流程一部分的电子版本中自动提供建议（优势比 [OR]=17.5；95%置信区间 [CI]：1.6-193.7）和出版年份（OR=6.7；95%CI：1.3-34.3）是统计学上显著的预测因素。
从已经进行的研究中，我们可以得出结论，实施 CCG 后，护理过程得到了显著改善。我们的研究结果还表明，临床医生、管理人员和其他医疗保健决策者，CCG 的哪些特征可能会改进计算机系统的结构。
