Table 2.
Characteristics of trials | Before 2009 (n=36) | 2009 onwards (n=93) | Total (n=129) |
---|---|---|---|
Targeted process of care: | |||
Prescribing | 24 (67) | 44 (47) | 68 (53) |
Test ordering | 12 (33) | 18 (19) | 30 (23) |
Documentation | 3 (8) | 22 (24) | 25 (19) |
Vaccination | 5 (14) | 7 (8) | 12 (9) |
Other | 7 (19) | 28 (30) | 35 (27) |
Study features: | |||
Randomised controlled trial | 30 (83) | 83 (89) | 113 (88) |
United States | 23 (64) | 62 (67) | 85 (66) |
Outpatient | 23 (64) | 70 (75) | 93 (72) |
No of providers (median (IQR)) | 89 (41-151) | 79 (36-171) | 81 (36-171) |
No of patients (median (IQR)) | 2254 (452-6275) | 2204 (450-11 282) | 2237 (450-8574) |
Baseline adherence (median (IQR)) | 29 (21-50) | 45 (17-64) | 39 (17-62) |
Co-interventions (education) | 12 (33) | 48 (52) | 60 (47) |
Co-interventions (non-education) | 8 (22) | 28 (30) | 36 (28) |
CDSS features: | |||
Push | 22 (61) | 72 (77) | 94 (73) |
Complex decision support | 3 (8) | 40 (43) | 43 (33) |
Acknowledgement and documentation | 2 (6) | 18 (19) | 20 (16) |
Execute action through CDSS | 14 (39) | 46 (49) | 60 (47) |
Ambush | 3 (8) | 30 (32) | 33 (26) |
Interruptive | 14 (39) | 45 (48) | 59 (46) |
Other concurrent CDSS | 2 (6) | 12 (13) | 14 (11) |
Consideration of alert fatigue | 4 (11) | 15 (16) | 19 (15) |
Target underuse | 27 (75) | 57 (61) | 84 (65) |
Commercial EHR (eg, Epic)* | 2 (6) | 39 (42) | 41 (32) |
CDSS=clinical decision support system; EHR=electronic health record; IQR=interquartile range.
Proportion of studies involving commercial systems increased significantly on or after 2009 compared with earlier (Bonferroni adjusted P<0.05).