title: Effectiveness of computerized clinical decision support systems for asthma and chronic obstructive pulmonary disease in primary care: a systematic review.
abstract: BACKGROUND
  The use of computerized clinical decision support systems may improve the diagnosis and ongoing management of chronic diseases, which requires recurrent visits to multiple health professionals, disease and medication monitoring and modification of patient behavior. The aim of this review was to systematically review randomized controlled trials evaluating the effectiveness of computerized clinical decision systems (CCDSS) in the care of people with asthma and COPD.
  
  
  METHODS
  Randomized controlled trials published between 2003 and 2013 were searched using multiple electronic databases Medline, EMBASE, CINAHL, IPA, Informit, PsychINFO, Compendex, and Cochrane Clinical Controlled Trials Register databases. To be included, RCTs had to evaluate the role of the CCDSSs for asthma and/or COPD in primary care.
  
  
  RESULTS
  Nineteen studies representing 16 RCTs met our inclusion criteria. The majority of the trials were conducted in patients with asthma. Study quality was generally high. Meta-analysis was not conducted because of methodological and clinical heterogeneity. The use of CCDSS improved asthma and COPD care in 14 of the 19 studies reviewed (74%). Nine of the nineteen studies showed statistically significant (p < 0.05) improvement in the primary outcomes measured. The majority of the studies evaluated health care process measures as their primary outcomes (10/19).
  
  
  CONCLUSIONS
  Evidence supports the effectiveness of CCDSS in the care of people with asthma. However there is very little information of its use in COPD care. Although there is considerable improvement in the health care process measures and clinical outcomes through the use of CCDSSs, its effects on user workload and efficiency, safety, costs of care, provider and patient satisfaction remain understudied.
authors.affiliation: Sydney Medical School, University of Sydney, Sydney, New South Wales, Australia. mfat5478@uni.sydney.edu.au.
authors.forename: Mariam
authors.initials: M
authors.lastname: Fathima
authors.forename: David
authors.initials: D
authors.lastname: Peiris
authors.forename: Pradnya
authors.initials: P
authors.lastname: Naik-Panvelkar
authors.forename: Bandana
authors.initials: B
authors.lastname: Saini
authors.forename: Carol Lyn
authors.initials: CL
authors.lastname: Armour
mesh_terms: D001249:Asthma / Q000175:diagnosis / Q000628:therapy*; D020000:Decision Support Systems, Clinical; D006801:Humans; D011320:Primary Health Care / Q000592:standards; D017064:Process Assessment, Health Care; D029424:Pulmonary Disease, Chronic Obstructive / Q000175:diagnosis / Q000628:therapy*; D016032:Randomized Controlled Trials as Topic; D016526:Workload