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Table 1 Overview of the main results

From: A systematic review of trials evaluating success factors of interventions with computerised clinical decision support

Factor Outcome Number of studies* Absolute improvement (RD)Ɨ Certainty of evidence (GRADE)ǂ
More versus less evidence-based CDS advice Adherence
2 5.0%
Range of ORs: 3.5 (CI 1.1–11.5) to 1.0 (CI 0.3–2.8)
Low
More versus less patient-specific CDS (by using additional patient data) Adherence 1 6.2%
3 3.0%, IQR 1.2 to 5.9 Moderate
Patient outcomes
3 8%, IQR 0 to 8.9 Low
More versus less explicit CDS advice (by providing recommendations or not) Adherence 1 −0.4%
1 1.0% Moderate
Patient outcomes
1 − 0.7% Moderate
More versus less explicit CDS advice (by presenting specific patient data or not) Adherence
1 − 4.0% Low
CDS that does (versus does not) require users to respond to the advice Adherence 1 0.1%
3 − 2.0%, IQR − 2.9 to 8.0 Low
CDS provided automatically by the system versus on demand by the user Adherence
3 22.2%, IQR 9.4 to 28.0 Low
CDS displayed on screen versus delivered on paper Adherence 1 15.6%
1 Range of ORs 0.3 (CI 0.1–1.0) to 0.7 (CI 0.2–2.1) Low
CDS combined with other professional-oriented strategies versus CDS only Adherence 3 4.8%, IQR  3.9 to 10.8
1 6.2% Low
Patient outcomes
2 − 0.5, IQR − 5 to 4 Low
CDS combined with patient-oriented strategies versus CDS only Adherence 10 3.1%, IQR − 2.0 to 5.0
5 2.8%, IQR 1.5 to 6.5 Moderate
Patient outcomes 1 − 5%
1 18.2% Low
CDS aimed at the patient versus CDS aimed at the healthcare provider Adherence 3 5.1%, IQR − 5.3 to 13.4
2 4.2%, IQR 0 to 8.3 Low
Patient outcomes
2 − 2.4%, IQR − 8.1 to 3.3 Low
CDS for physician and another provider type versus CDS for physician only Adherence 1 4.1%, IQR 3.4 to 7.2
2 5.2%, IQR 4.4 to 6 Moderate
Patient outcomes
2 1.4% (IQR + 1 to + 1.7) Low
  1. *The upper row presents the results for the primary analyses (normal print) and the lower row presents the secondary analyses data (in italics). The primary analyses only included studies with risk differences that were adjusted for baseline differences; the secondary analyses present results for studies where it was not possible to adjust for baseline differences
  2. ƗThe results of the studies are presented as absolute improvement (risk difference). We present the median and interquartile range (IQR) if multiple studies were available for an analysis. Odds ratios (OR) and 95% confidence intervals (CI) are presented if no risk data was available
  3. ǂGRADE Working Group grades of evidence: High certainty : Further research is very unlikely to change our confidence in the estimate of effect. Moderate certainty ⃝: Further research is likely to have an important impact on our confidence in the estimate of effect and may change the estimate. Low certainty ⃝⃝: Further research is very likely to have an important impact on our confidence in the estimate of effect and is likely to change the estimate. Very low certainty ⃝⃝⃝: We are very uncertain about the estimate