title: The multimedia computer for office-based patient education: a systematic review.
abstract: Use of the multimedia computer for education is widespread in schools and businesses, and yet computer-assisted patient education is rare. In order to explore the potential use of computer-assisted patient education in the office setting, we performed a systematic review of randomized controlled trials (search date April 2004 using MEDLINE and Cochrane databases). Of the 26 trials identified, outcome measures included clinical indicators (12/26, 46.1%), knowledge retention (12/26, 46.1%), health attitudes (15/26, 57.7%), level of shared decision-making (5/26, 19.2%), health services utilization (4/26, 17.6%), and costs (5/26, 19.2%), respectively. Four trials targeted patients with breast cancer, but the clinical issues were otherwise diverse. Reporting of the testing of randomization (76.9%) and appropriate analysis of main effect variables (70.6%) were more common than reporting of a reliable randomization process (35.3%), blinding of outcomes assessment (17.6%), or sample size definition (29.4%). We concluded that the potential for improving the efficiency of the office through computer-assisted patient education has been demonstrated, but better proof of the impact on clinical outcomes is warranted before this strategy is accepted in the office setting.
authors.affiliation: Department of Internal Medicine, Wake Forest University School of Medicine, Medical Center Blvd, Winston-Salem, NC 27157, USA.
authors.forename: James L
authors.initials: JL
authors.lastname: Wofford
authors.forename: Edward D
authors.initials: ED
authors.lastname: Smith
authors.forename: David P
authors.initials: DP
authors.lastname: Miller
mesh_terms: D001292:Attitude to Computers; D001294:Attitude to Health; D001315:Australia; D003194:Computer-Assisted Instruction / Q000191:economics / Q000592:standards*; D003362:Cost-Benefit Analysis; D004521:Educational Measurement; D017598:Efficiency, Organizational; D005060:Europe; D007722:Health Knowledge, Attitudes, Practice; D006296:Health Services / Q000706:statistics & numerical data; D006801:Humans; D020407:Internet; D008838:Microcomputers; D019212:Multimedia / Q000191:economics / Q000592:standards*; D020380:Needs Assessment; D009656:North America; D009819:Office Visits; D017063:Outcome Assessment, Health Care; D010353:Patient Education as Topic / Q000191:economics / Q000379:methods* / Q000592:standards; D015397:Program Evaluation; D016032:Randomized Controlled Trials as Topic; D012107:Research Design