Effectiveness of clinical dashboards as audit and feedback or clinical decision support tools on medication use and test ordering: a systematic review of randomized controlled trials

Xie, CX (通讯作者),Queen Mary Univ London, Barts & London Sch Med & Dent, Wolfson Inst Populat Hlth, Yvonne Carter Bldg,58 Turner St, London E1 2AB, England.
2022-9-12
Background Clinical dashboards used as audit and feedback (A&F) or clinical decision support systems (CDSS) are increasingly adopted in healthcare. However, their effectiveness in changing the behavior of clinicians or patients is still unclear. This systematic review aims to investigate the effectiveness of clinical dashboards used as CDSS or A&F tools (as a standalone intervention or part of a multifaceted intervention) in primary care or hospital settings on medication prescription/adherence and test ordering. Methods Seven major databases were searched for relevant studies, from inception to August 2021. Two authors independently extracted data, assessed the risk of bias using the Cochrane RoB II scale, and evaluated the certainty of evidence using GRADE. Data on trial characteristics and intervention effect sizes were extracted. A narrative synthesis was performed to summarize the findings of the included trials. Results Eleven randomized trials were included. Eight trials evaluated clinical dashboards as standalone interventions and provided conflicting evidence on changes in antibiotic prescribing and no effects on statin prescribing compared to usual care. Dashboards increased medication adherence in patients with inflammatory arthritis but not in kidney transplant recipients. Three trials investigated dashboards as part of multicomponent interventions revealing decreased use of opioids for low back pain, increased proportion of patients receiving cardiovascular risk screening, and reduced antibiotic prescribing for upper respiratory tract infections. Conclusion There is limited evidence that dashboards integrated into electronic medical record systems and used as feedback or decision support tools may be associated with improvements in medication use and test ordering.
JOURNAL OF THE AMERICAN MEDICAL INFORMATICS ASSOCIATION
卷号:29|期号:10|页码:1773-1785
ISSN:1067-5027|收录类别:SCIE
语种
英语
来源机构
University of London; Queen Mary University London; University of Sydney; University of Geneva; University of Zurich; University of Zurich; University of Zurich
被引频次(WOS)
1
被引频次(其他)
1
180天使用计数
3
2013以来使用计数
5
EISSN
1527-974X
出版年
2022-9-12
DOI
10.1093/jamia/ocac094
学科领域
循证公共卫生
关键词
dashboard audit and feedback clinical decision support review
WOS学科分类
Computer Science, Information Systems Computer Science, Interdisciplinary Applications Health Care Sciences & Services Information Science & Library Science Medical Informatics