Upgrading clinical decision support with published evidence: what can make the biggest difference?

E. Andrew Balas, Kui Chun Su, Jan Frederik Solem, Zong Rong Li, Gordon Brown

Research output: Chapter in Book/Report/Conference proceedingChapter

2 Scopus citations


Background To enhance clinical decision support, presented messages are increasingly supplemented with information from the medical literature. The goal of this study was to identify types of evidence that can lead to the biggest difference. Methods Seven versions of a questionnaire were mailed to randomly selected active family practice physicians and internists across the United States. They were asked about the perceived values of evidence from randomized controlled trials, locally developed recommendations, no evidence, cost-effectiveness studies, expert opinion, epidemiologic studies, and clinical studies. Analysis of variance and pairwise comparisons were used for statistical testing. Results Seventy-six (52%) physicians responded On a Likert scale from one to six, randomized controlled clinical trial was the highest rated evidence (mean 5.07, SD±1.14). Such evidence was significantly superior to locally developed recommendations and no evidence at all (P<.05). The interaction was also strong between the types of evidence and clinical areas (P=.0001). Conclusion While most health care organizations present data without interpretation or simply try to enforce locally developed recommendations, such approaches appear to be inferior to techniques of reporting data with pertinent controlled evidence from the literature. Investigating physicians' perceptions is likely to benefit the design of computer generated messages.

Original languageEnglish (US)
Title of host publicationStudies in Health Technology and Informatics
Number of pages4
Publication statusPublished - Jan 1 1998
Externally publishedYes
Event9th World Congress on Medical Informatics, MedInfo 1998 - Seoul, Korea, Republic of
Duration: Aug 18 1998Aug 22 1998


Other9th World Congress on Medical Informatics, MedInfo 1998
CountryKorea, Republic of



  • Clinical trial
  • Cost-effectiveness
  • Epidemiologic study
  • Evidence
  • Expert opinion
  • Perception
  • Physicians
  • Preference
  • Randomized controlled trial

ASJC Scopus subject areas

  • Biomedical Engineering
  • Health Informatics
  • Health Information Management

Cite this

Balas, E. A., Su, K. C., Solem, J. F., Li, Z. R., & Brown, G. (1998). Upgrading clinical decision support with published evidence: what can make the biggest difference? In Studies in Health Technology and Informatics (Pt2 ed., Vol. 52, pp. 845-848) https://doi.org/10.3233/978-1-60750-896-0-845