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Table 2 Effect of CDSS on proportion of appropriate tests. All values are absolute differences with 95% confidence intervals unless specified otherwise

From: Clinical decision support improves the appropriateness of laboratory test ordering in primary care without increasing diagnostic error: the ELMO cluster randomized trial

 

Proportion appropriate tests

Difference in proportions

p value

CDSS arm

Control arm

Primary outcome (all tests)

0.58 (0.54–0.62)

0.38 (0.34–0.41)

0.21 (0.16–0.26)

< 0.0001

Subgroups per indication

 Check-up

0.26 (0.24–0.28)

0.17 (0.16–0.19)

0.08 (0.06–0.11)

< 0.0001

 Medication follow-up

0.78 (0.75–0.82)

0.74 (0.70–0.78)

0.04 (0.00–0.09)

0.0591

 Cardiovascular disease management

0.41 (0.37–0.45)

0.30 (0.28–0.32)

0.11 (0.07–0.15)

< 0.0001

 Hypertension

0.47 (0.43–0.50)

0.39 (0.35–0.42)

0.08 (0.03–0.12)

0.0007

 Type 2 diabetes

0.51 (0.47–0.54)

0.38 (0.35–0.41)

0.13 (0.08–0.17)

< 0.0001

 Fatigue

0.81 (0.79–0.83)

0.67 (0.64–0.70)

0.14 (0.10–0.17)

< 0.0001

 Anemia

0.82 (0.81–0.84)

0.76 (0.74–0.78)

0.06 (0.03–0.09)

< 0.0001

 Liver disease

0.56 (0.53–0.59)

0.43 (0.39–0.46)

0.13 (0.08–0.18)

< 0.0001

 Gout

0.27 (0.23–0.31)

0.16 (0.14–0.18)

0.11 (0.06–0.16)

< 0.0001

 Chronic kidney disease

0.66 (0.61–0.70)

0.51 (0.46–0.56)

0.14 (0.09–0.20)

< 0.0001

 Acute coronary syndrome

0.06 (0.05–0.07)

0.04 (0.02–0.05)

0.02 (0.01–0.04)

0.0081

 Lung embolisma

0.06 (0.02–0.10)

0.02 (0.01–0.04)

0.03 (− 0.01–0.08)

0.1608

 Rheumatoid arthritis

0.79 (0.76–0.82)

0.61 (0.56–0.66)

0.18 (0.12–0.24)

< 0.0001

 Thyroid disease

0.50 (0.47–0.54)

0.45 (0.42–0.49)

0.05 (0.01–0.09)

0.0136

 Sexually transmitted infections

0.29 (0.23–0.36)

0.33 (0.27–0.39)

− 0.04 (− 0.13–0.06)

0.4719

 Acute diarrhea

0.54 (0.46–0.62)

0.33 (0.28–0.38)

0.22 (0.10–0.33)

0.0002

 Chronic diarrhea

0.41 (0.34–0.49)

0.25 (0.22–0.29)

0.16 (0.08–0.24)

0.0001

  1. CDSS clinical decision support system
  2. aNumbers do not include corrections for the laboratory and the number of study indications per panel