A critical appraisal of the literature on the effects of computer-based clinical decision support systems on clinician performance and patient outcomes.
OBJECTIVE
To review the evaluations of computer-based clinical decision support systems (CDSS's).


METHODS
The literature collected in the MEDLARS, EMBASE, SCISEARCH and INSPEC databases was searched from 1974 to the present. The reference lists of relevant articles were reviewed as were conference proceedings.


METHODS
Prospective, controlled studies were included. Studies were rated for methodological quality.


METHODS
Study quality was assessed and data on study setting, subjects, method of allocation, and computer system were collected and verified using a structured form.


CONCLUSIONS
There is considerable heterogeneity in both systems evaluated and design features of those systems. Future evaluations of CDSS's should focus on methodological issues in order to enhance overall quality of evaluations.
Langton
K B
KB
Health Information Research Unit, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada.
Johnston
M E
ME
Haynes
R B
RB
Mathieu
A
A
D015510:Clinical Medicine; D003658:Decision Making, Computer-Assisted; D005069:Evaluation Studies as Topic; D009862:Online Systems; D016896:Treatment Outcome