Project: Research project

Project Details


Computerized information systems could greatly improve primary health
care delivery. However, claims of benefits are often based on
non-experimental evidence. Randomized controlled clinical computer
trials (RCTs) can rigorously assess the value of computer technology in
practice. A review of these trials would provide a useful evaluation of
the current status of this technology. Unfortunately, several obstacles
exist that make a review of computer RCTs difficult. These include the
large variety of medical and information science publications in which
reports may appear, non-standard descriptors, incomplete indexing, and
submission/selection bias against the null hypothesis. The purpose of this project is to provide a comprehensive database and
review of computer RCTs to assist the selection of computer services with
demonstrated ability to improve the quality of patient care. A database of computer RCTs is proposed to register published reports of
trials, unpublished trials, and reported ongoing or planned trials. The
registration will follow a stepwise protocol: 1) Systematic search for
trial reports. Several methods will be combined to ensure completeness:
(a) MEDLINE and other database searches with various strategies, (b) hand
search of selected books, before 1966 journals, citations in articles
reviewed, and proceedings (abstracts), (c) other informal methods (e.g.
letters, electronic mail, meetings). Only reports on clinical trials
evaluating effects in the process or outcome of patient care will be
collected. 2) Registration of retrieved trial reports. Using specific
eligibility criteria a decision about registration (inclusion/exclusion)
of the retrieved trial reports will be made. In case of ambiguity the
authors will be contacted. Registered reports will be entered into a
database supporting linked access to repeat publications and trials
testing similar interventions, measuring similar outcome parameters, or
using similar subjects. 3) Blinded classification of the reported trial
features. Considering the potential bias of conventional reviewing, a
blinded review method will be applied to analyze the methods and results
of the large variety of computer trials. The procedure will be based on
independent evaluations and consensus development. The review will
result in a classification of computer RCTs according to the method of
intervention, site of the trial, study population, treated condition, and
the outcome of the trial.
Effective start/end date6/1/935/31/94


  • National Institutes of Health


  • Medicine(all)


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