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Table 1 Summary of Findings for comparison one: Electronic multidimensional guidelines versus usual care

From: Effectiveness of electronic guideline-based implementation systems in ambulatory care settings - a systematic review

Study Risk of bias No of patients/professionals Intervention Outcomes
     Process Patient
Christakis[21]
Cluster-RCT
low 1,339 visits for OM, 38 physicians Evidence-based (EB) message system presenting real time evidence to providers based on their prescribing practice for otitis media (OM). Y  
Davis[10]
Cluster-RCT
low 12,195 visits, 44 healthcare providers EB message system that presented real-time evidence to providers based on prescribing practices for acute otitis media, allergic rhinitis, sinusitis, constipation, pharyngitis, croup, urticaria, and bronchiolitis Y  
Meigs[12]
Cluster-RCT
moderate 598 patients, 66 healthcare providers Diabetes management application, (DMA); interactive patient-specific clinical data, treatment advice, and links to other web-based resources N N
Montgomery[26]
Cluster-RCT
moderate 614 patients, 27 general practices Computer-based clinical decision support system and a risk chart on absolute cardiovascular risk, blood pressure, and prescribing of cardiovascular drugs in hypertensive patients. N N
Rollman[13]
Cluster-RCT
moderate 200 patients, 17 primary care physicians Guideline-based treatment advice for depression
Active care
Passive care
N
N
N
N
van Wyk[32]
Cluster-RCT
moderate 87,866 patients, 77 primary care physicians Clinical decision support system with respect to screening and treatment of dyslipidemia
Alerting version
On-demand version
Y
N
 
Carton[36]
ITS design
high 6,869 radiological examinations in sample Reminder on screen, indicating the appropriate recommendations concerning radiology requests N  
Day[18]
ITS design
high off: 103 patients
on: 258 patients off: 125 patients
Real-time advice regarding documentation, testing, treatment and disposition of emergency department patients with low back pain (EDECS) N  
Hetlevik '99[34]
Cluster-RCT
high 2,230 patients, 53 physicians Clinical decision support system for hypertension   N
Hetlevik '00[35]
Cluster-RCT
high 1,034 patients, 53 physicians Clinical decision support system for diabetes mellitus   N
Hicks[22]
Cluster-RCT
high 2,027 patients, 14 primary care practices Electronic decision support for hypertensive patients Y N
McCowan[25]
Cluster-RCT
high 477 patients, 17 practices Computerized decision support system for the management of asthma N N
Poley[29]
CBA design
high 109 primary care physicians Guideline-driven decision-support system for ordering blood tests in primary care N  
Safran[23]
CCT
high 349 patients in analysis, 126 physicians and nurses Reminders and alerts for HIV infection Y N
Schriger '97[19]
ITS design
high off: 50 patients
on: 156 patients
off: 74 patients
Real-time advice regarding documentation, testing, treatment and disposition of emergency department patients regarding the management of body fluid exposure (EDECS) Y  
Schriger '00[20]
ITS design
high off: 352 patients
on: 374 patients
off: 104 patients
Real-time advice regarding documentation, testing and treatment of children with fever presenting in the emergency department (EDECS) N  
Sequist[14]
Cluster-RCT
high Diabetes: 4,549 patients - CAD: 2,199 patients, 194 physicians EB electronic reminders for diabetes and coronary artery disease (CAD) N  
Szpunar[11]
CBA design
high Pre: 5,334 patients - Post: 3,970 patients, 6 clinics Tobacco Use Cessation (TUC) Automated Clinical Practice Guideline Y  
Martens[33]
Cluster-RCT
high 53 primary care physicians Intervention group one: Reminders on antibiotics, asthma/chronic obstructive pulmonary disease (COPD)
Intervention group two: Reminders on cholesterol-lowering drugs
N  
  1. Y = if at least 50% of outcomes significant, N = if less than 50% of outcomes significant