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. 2022 Jun 11;29(10):1773–1785. doi: 10.1093/jamia/ocac094

Table 2.

Summary of findings

Study Time frame Outcomes
Trial groups Intervention (I) Control (C) Medication prescription/adherence Test ordering Quality of the evidence (GRADE)
Computerized feedback dashboard compared with usual care/no intervention (n = 8)

  • Linder et al17

  • USA

 9-mo intervention period

  • I: 14 primary care practices (258 clinicians, 8406 visits for acute respiratory infection)

  • C: 13 primary care practices (315 clinicians, 10 082 visits for acute respiratory infection)

  • Antibiotic prescribing rate for all acute respiratory infection visits: OR = 0.97; 95% CI = 0.70–1.40

  • Antibiotic prescribing rate for antibiotic-appropriate acute respiratory infection visits: I : 63% vs C: 68%; OR = 0.78; 95% CI = 0.53–1.15

  • Antibiotic prescribing rate for non–antibiotic-appropriate acute respiratory infection visits: I: 32% vs C: 43%;

  • OR = 0.63; 95% CI = 0.45, 0.86

 Not reported Moderate

  • Patel et al18

  • USA

 2-mo intervention period

  • I (dashboard): 32 physicians and 1743 patients with atherosclerotic cardiovascular disease (ASCVD)

  • I (dashboard with peer comparison): 32 physicians and 1465 patients with ASCVD

  • C: 32 physicians and 1566 patients with ASCVD

  • Statin prescribing rate for atherosclerotic cardiovascular disease:

  • Dashboard only vs usual care: adjusted difference in percentage points, 4.1; 95% CI = −0.8 to 13.1

  • Dashboard with peer comparison vs usual care: adjusted difference in percentage points, 5.8; 95% CI, 0.9–13.5

 Not reported High

  • EI Miedany et al19

  • Europe

  • 6-mo

  • intervention period; (outcome measured over 12 mo)

  • I: 55 patients diagnosed with early inflammatory arthritis and receiving disease-modifying antirheumatic drug therapy

  • C: 56 patients diagnosed with early inflammatory arthritis and receiving disease-modifying antirheumatic drugs therapy

 Medication adherence for disease-modifying antirheumatic drug therapy: I: 87% of patients vs. C: 43% of patients, P < .01 (no point estimates and 95% CI reported) Not reported Low

  • Ryskina et al20

  • USA

 6-mo intervention period

  • I: 39 medicine interns and residents

  • C: 34 medicine interns and residents

  • 41 in crossover group: 19 control first then intervention; 22 intervention first then control (114 participants in total)

 Count of routine laboratory test orders: −0.14; 95% CI −0.56 to 0.27 Moderate

  • Chang et al22

  • China

 6-mo intervention period

  • Group 1 (received intervention first then control): 82 primary care physicians

  • Group 2 (received control first then intervention): 81 primary care physicians

 10-d antibiotic prescription rate: coef. −0.04, 95% CI −0.07 to −0.01 Not reported Very low

  • Jung et al24

  • South Korea

 24-wk intervention period

  • I: 57 kidney transplant recipients

  • C: 57 kidney transplant recipients

 Medical adherence among kidney transplant recipients: no significant between-group difference (no point estimates and 95% CI reported) Not reported Very low

  • Hemkens et al26

  • Switzerland

 2-y follow-up

  • I: 1450 primary care physicians

  • C: 1450 primary care physicians

  • Defined daily doses (DDD) of antibiotic items to any patient per 100 consultations:

  • First year: 0.81%; 95% CI, −2.56% to 4.30%

  • Second year: −1.73%; 95% CI, −5.07% to 1.72%

 Not reported High

  • Elouafkaoui et al27

  • UK

 12-mo intervention period

  • I: 632 general dental practices (1999 dentists)

  • C: 163 general dental practices (567 dentists)

  • Number of antibiotic items dispensed per 100 NHS treatment claims: −5.7%; 95% CI −10.2% to −1.1%

  • Defined daily dose (DDD) prescribing rates per 100 NHS treatment claims: −6.6%; 95% CI −12.5% to −0.7%

  • Number of amoxicillin 3g dispensed per 100 NHS treatment claims: −26.0%; 95% CI −64.9% to 13.0%

  • Number of broad-spectrum antibiotics dispensed per 100 NHS treatment claims: −33.3%; 95% CI −80.0% to 20.0%

 Not reported Moderate
Multifaceted interventions incorporating a dashboard component compared with usual care/no intervention (n = 2)

  • Coombs et al21

  • Australia

 4-mo intervention period

  • I: 4 emergency departments (1392 episodes of care for low back pain)

  • C: 4 emergency departments (3233 episodes of care for low back pain)

  • Opioid administration rate: OR 0.57; 95% CI 0.38–0.85

  • Strong opioids administration rate: OR 0.69, 95% CI 0.46–1.04

  • Nonopioid pain medicines administration rate: OR 1.52, 95% CI 0.98–2.3

 Lumbar imaging referral rate: OR 0.77; 95% CI 0.47–1.26 High

  • Peiris et al25

  • Australia

  • Median follow-up for intervention and control arms was 17.3 and 17.7 mo

  • I: 30 general practice services (19 385 patients at high CVD risk)

  • C: 30 general practice services (19 340 patients at high CVD risk)

 Appropriate medication prescription rate: RR 1.11; 95% CI, 0.97–1.27

  1. antiplatelet medications: RR 4.80; 95% CI 2.47–9.29

  2. lipid-lowering medications: RR 3.22; 95% CI 1.77–5.88

  3. blood pressure-lowering medications: RR 1.89; 95% CI, 1.08–3.28

 Appropriate CVD risk screening rate: RR 1.25; 95% CI 1.04–1.50 Moderate
Multifaceted interventions incorporating a dashboard component compared with similar system without dashboard component (n = 1)

  • Du et al23

  • USA

 11-mo intervention period

  • I: 22 primary care clinicians

  • C: 23 primary care clinicians

  • Antibiotic prescription rates for:

  • Upper respiratory infection: ITR 0.60, 95% CI 0.47–0.77

  • Bronchitis: ITR 0.42, 95% CI 0.32–0.55

  • Sinusitis: ITR 1.05, 95% CI 0.91–1.21

  • Pharyngitis: ITR 0.91, 95% CI 0.76–1.09

 Not reported Moderate