title: Comparison of electronic physician prompts versus waitroom case-finding on clinical trial enrollment.
abstract: BACKGROUND
  Recruiting patients into clinical research protocols is challenging. Electronic medical record (EMR) systems capable of prompting clinicians may facilitate enrollment.
  
  
  OBJECTIVE
  To compare an EMR-based clinician prompt versus a wait-room-based case-finding strategy at enrolling patients into a clinical trial.
  
  
  METHODS
  Cross-sectional comparison of recruitment data from two trials to treat anxiety disorders in primary care. Both studies utilized similar enrollment criteria, intervention strategies, and the same four practice sites and EMR system.
  
  
  METHODS
  Patients referred by their (primary care physicians) PCPs in response to an EMR prompt (recruited 1/2005-10/2006), and patients enrolled by research assistants stationed in practice waiting rooms (7/2000-4/2002).
  
  
  METHODS
  Referral counts, patients' baseline sociodemographic and clinical characteristics.
  
  
  RESULTS
  Over a 22-month period, EMR-prompted PCPs referred 794 patients and 176 (22%) met study inclusion criteria and enrolled, compared to 8,095 patients approached by wait room-based recruiters of whom 193 (2.4%) enrolled. Subjects enrolled by EMR-prompted PCPs were more likely to be non-white (23% vs 5%; P < 0.001), male (28% vs 18%; P = 0.03), and have higher anxiety levels than those recruited by wait-room recruiters (P < 0.0001).
  
  
  CONCLUSIONS
  EMR systems prompting clinicians to refer patients with specific characteristics are an efficient recruitment tool with critical implications for increasing minority participation in clinical research.
authors: Division of General Internal Medicine, Center for Research on Health Care, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA. rollmanbl@upmc.edu
authors: Bruce L
authors: BL
authors: Rollman
authors: Gary S
authors: GS
authors: Fischer
authors: Fang
authors: F
authors: Zhu
authors: Bea Herbeck
authors: BH
authors: Belnap
mesh_terms: D000328:Adult; D002986:Clinical Trials as Topic; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D016347:Medical Records Systems, Computerized; D008875:Middle Aged; D016584:Panic Disorder / Q000628:therapy; D018579:Patient Selection; D011320:Primary Health Care; D017010:Reminder Systems