Effectiveness of Topic-specific Infobuttons: A randomized Controlled Trial
Effectiveness of Topic-specific Infobuttons: A randomized Controlled Trial
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DOI：
10.1197/jamia.m2725
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发表时间：
2008-11-01
影响因子：
6.4
通讯作者：
Mitchell, Joyce A.
中科院分区：
文献类型：
--
作者：
Del Fiol, Guilherme;Haug, Peter J.;Mitchell, Joyce A.
目的：信息按钮是决策支持工具，可在电子病历系统内提供与在线信息资源中相关内容的链接。infobuttons的目的是帮助临床医生及时满足他们的信息需求。本研究的目的是确定是否infobutton链接，直接到特定的内容主题（“主题链接”）是更有效的链接，指向一般概述的内容（“非特定链接”）。设计：随机对照试验的控制和干预组。对照组的临床医生可以访问非特定的链接，而干预组的临床医生可以访问主题links.Measurements：Infobutton会话持续时间，infobutton会话的数量，会话成功率，以及自我报告的影响，infobutton会话产生的决策making.Results：该分析是在90名受试者和3,729 infobutton会话。与对照组相比，干预组的受试者花费在寻找信息上的时间减少了17.4%（35.5秒对43秒，p = 0.008）。干预组的受试者使用信息按钮的频率比对照组高20.5%（22次与17.5次，p = 0.21），但差异不显著。两组的信息寻求成功率同样高（对照组89.4%，干预组87.2%，p = 0.99）。受试者报告了高度积极的临床影响（即，局限性：排除使用infobutton频率较低的用户和关注药物相关信息需求可能会限制结果的推广，会话结局测量基于临床医生的setf评估，因此容易产生偏倚。结论：研究结果支持了主题链接比非特定链接更有效的假设。尚不清楚所证明的统计学差异是否会导致临床显著影响。然而，总体结果证实了先前的证据，即信息按钮在帮助临床医生回答护理问题方面是有效的，并证明了该工具的常规用户的信息传递效率的适度增量变化。
Objective: Infobuttons are decision support tools that provide links within electronic medical record systems to relevant content in online information resources. The aim of infobuttons is to help clinicians promptly meet their information needs. The objective of this Study was to determine whether infobutton links that direct to specific content topics ("topic links") are more effective than links that point to general overview content ("nonspecific links").Design: Randomized controlled trial with a control and an intervention group. Clinicians in the control group had access to nonspecific links, while those in the intervention group had access to topic links.Measurements: Infobutton session duration, number of infobutton sessions, session success rate, and the self-reported impact that the infobutton session produced on decision making.Results: The analysis was performed On 90 Subjects and 3,729 infobutton sessions. Subjects in the intervention group spent 17.4% less time seeking for information (35.5 seconds vs. 43 seconds, p = 0.008) than those in the control group. Subjects in the intervention group used infobuttons 20.5% (22 sessions vs. 17.5 sessions, p = 0.21) more often than in the control group, but the difference was not significant. The information seeking success rate was equally high in both groups (89.4%, control vs. 87.2% intervention, p = 0.99). Subjects reported a high positive clinical impact (i.e., decision enhancement or knowledge update) in 62% of the sessions.Limitations: The exclusion Of users with a low frequency of infobutton use and the focus on medication-related information needs may limit the generalization of the results, The session outcomes measurement was based on clinicians' setf-assessment and therefore prone to bias.Conclusion: The results support the hypothesis that topic links are more efficient than nonspecific links regarding the time seeking for information. It is unclear whether the statistical difference demonstrated will result in a clinically significant impact. However, the overall results confirm previous evidence that infobuttons are effective at helping clinicians to answer questions at the point of care and demonstrate a modest incremental change in the efficiency of information delivery for routine users of this tool.