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2
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Use of reminders for preventive procedures in family medicine.家庭医学中预防性程序提醒的应用。
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Implementing antibiotic practice guidelines through computer-assisted decision support: clinical and financial outcomes.通过计算机辅助决策支持实施抗生素应用指南：临床和财务结果
Ann Intern Med. 1996 May 15;124(10):884-90. doi: 10.7326/0003-4819-124-10-199605150-00004.
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Philosophies for the design and development of clinical decision-support systems.
Methods Inf Med. 1993 Feb;32(1):1-8; discussion 9-17.
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Physician inpatient order writing on microcomputer workstations. Effects on resource utilization.医生在微型计算机工作站上书写住院医嘱。对资源利用的影响。
JAMA. 1993 Jan 20;269(3):379-83.
4
Requiring physicians to respond to computerized reminders improves their compliance with preventive care protocols.要求医生对计算机化提醒做出回应可提高他们对预防保健方案的依从性。
J Gen Intern Med. 1993 Jun;8(6):311-7. doi: 10.1007/BF02600144.
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Effects of computer-based clinical decision support systems on clinician performance and patient outcome. A critical appraisal of research.基于计算机的临床决策支持系统对临床医生表现及患者预后的影响。一项研究的批判性评价。
Ann Intern Med. 1994 Jan 15;120(2):135-42. doi: 10.7326/0003-4819-120-2-199401150-00007.
6
Promoting screening mammography in inner-city settings: a randomized controlled trial of computerized reminders as a component of a program to facilitate mammography.在市中心地区推广乳腺钼靶筛查：一项将计算机提醒作为促进乳腺钼靶检查项目组成部分的随机对照试验。
Med Care. 1994 Jun;32(6):609-24. doi: 10.1097/00005650-199406000-00006.
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Internists' attitudes about clinical practice guidelines.内科医生对临床实践指南的态度。
Ann Intern Med. 1994 Jun 1;120(11):956-63. doi: 10.7326/0003-4819-120-11-199406010-00008.
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Preventive health services in adults.
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Computer-based vs manual health maintenance tracking. A controlled trial.
Arch Fam Med. 1994 Jul;3(7):581-8. doi: 10.1001/archfami.3.7.581.
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Computer-generated informational messages directed to physicians: effect on length of hospital stay.针对医生的计算机生成信息：对住院时间的影响。
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一项对16项随机对照试验的荟萃分析，以评估门诊环境中基于计算机的预防保健临床提醒系统。

A meta-analysis of 16 randomized controlled trials to evaluate computer-based clinical reminder systems for preventive care in the ambulatory setting.

作者信息

Shea S, DuMouchel W, Bahamonde L

机构信息

Department of Medicine, College of Physicians and Surgeons, Columbia University, New York, NY, USA.

出版信息

J Am Med Inform Assoc. 1996 Nov-Dec;3(6):399-409. doi: 10.1136/jamia.1996.97084513.

DOI:10.1136/jamia.1996.97084513
PMID:8930856
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC116324/
Abstract

OBJECTIVE

Computer-based reminder systems have the potential to change physician and patient behaviors and to improve patient outcomes. We performed a meta-analysis of published randomized controlled trials to assess the overall effectiveness of computer-based reminder systems in ambulatory settings directed at preventive care.

DESIGN

Meta-analysis.

SEARCH STRATEGY

Searches of the Medline (1966-1994), Nursing and Allied Health (1982-1994), and Health Planning and Administration (1975-1994) databases identified 16 randomized, controlled trials of computer-based reminder systems in ambulatory settings.

STATISTICAL METHODS

A weighted mixed effects model regression analysis was used to estimate intervention effects for computer and manual reminder systems for six classes of preventive practices.

MAIN OUTCOME MEASURE

Adjusted odds ratio for preventive practices.

RESULTS

Computer reminders improved preventive practices compared with the control condition for vaccinations (adjusted odds ratio [OR] 3.09; 95% confidence interval [CI] 2.39-4.00), breast cancer screening (OR 1.88; 95% CI 1.44-2.45), colorectal cancer screening (OR 2.25; 95% CI 1.74-2.91), and cardiovascular risk reduction (OR 2.01; 95% CI 1.55-2.61) but not cervical cancer screening (OR 1.15; 95% CI 0.89-1.49) or other preventive care (OR 1.02; 95% CI 0.79-1.32). For all six classes of preventive practices combined the adjusted OR was 1.77 (95% CI 1.38-2.27).

CONCLUSION

Evidence from randomized controlled studies supports the effectiveness of data-driven computer-based reminder systems to improve prevention services in the ambulatory care setting.

摘要

目的

基于计算机的提醒系统有可能改变医生和患者的行为，并改善患者的治疗效果。我们对已发表的随机对照试验进行了荟萃分析，以评估基于计算机的提醒系统在门诊环境中针对预防保健的总体有效性。

设计

荟萃分析。

检索策略

检索Medline（1966 - 1994年）、护理及相关健康（1982 - 1994年）和健康规划与管理（1975 - 1994年）数据库，确定了16项关于门诊环境中基于计算机的提醒系统的随机对照试验。

统计方法

采用加权混合效应模型回归分析，估计计算机提醒系统和人工提醒系统对六类预防措施的干预效果。

主要观察指标

预防措施的调整优势比。

结果

与对照条件相比，计算机提醒在疫苗接种（调整优势比[OR]3.09；95%置信区间[CI]2.39 - 4.00）、乳腺癌筛查（OR 1.88；95% CI 1.44 - 2.45）、结直肠癌筛查（OR 2.25；95% CI 1.74 - 2.91）和心血管风险降低（OR 2.01；95% CI 1.55 - 2.61）方面改善了预防措施，但在宫颈癌筛查（OR 1.15；95% CI 0.89 - 1.49）或其他预防保健方面没有改善（OR 1.02；95% CI 0.79 - 1.32）。对于所有六类预防措施综合起来，调整后的OR为1.77（95% CI 1.38 - 2.27）。

结论

随机对照研究的证据支持基于数据驱动的计算机提醒系统在门诊护理环境中改善预防服务的有效性。