Effect of physician reminders on preventive care: meta-analysis of randomized clinical trials.
Effect of physician reminders on preventive care: meta-analysis of randomized clinical trials.
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发表时间：
1994
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通讯作者：
S. M. Austin;E. Balas;Joyce A. Mitchell;B. Ewigman
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作者：
S. M. Austin;E. Balas;Joyce A. Mitchell;B. Ewigman
这项研究的目的是评估医生提醒的临床价值，这是一种信息干预，在提高对选定的预防保健措施的依从性方面。Meta分析用于结合符合资格标准的随机对照临床试验的定量证据。这项荟萃分析中包含的试验是在家庭或内科诊所进行的。在试验中使用医生提醒来影响预防性卫生保健活动的利用和依从性。在预防保健活动中使用医生提醒，对子宫颈癌筛查(异质性检验X2(2)=4.122，不显著)和破伤风免疫(异质性检验X2(2)=3.139，不显著)的子类别产生了相同的效果。同样，来自三个宫颈癌筛查试验的证据组合的优势比是显著的(1.180，95%CI：1.020至1.339)。综合三项破伤风免疫试验的证据得出的优势比非常显著(2.819，95%可信区间：2.664比2.975)。对宫颈癌筛查和破伤风疫苗接种的Meta分析结果表明，医生提醒是一种有效的信息干预措施，可以提高这两种预防性保健程序的依从性。根据这一荟萃分析的结果，进一步的试验测试医生提醒对破伤风免疫的影响将是不必要的，而且可能是不道德的。
The objective of this study was to assess the clinical value of the physician reminder, an information intervention, in increasing compliance for selected preventive health care measures. Meta-analysis was used to combine the quantitative evidence from randomized controlled clinical trials meeting the eligibility criteria. The trials included in this meta-analysis were conducted in a family or internal medicine clinic. Physician reminders were used in the trials to influence utilization and compliance of preventive health care activities. The use of physician reminders for preventive health care activities resulted in a homogeneous effect for the subcategories of cervical cancer screening (test for heterogeneity X2(2) = 4.122, non-significant) and tetanus immunization (test for heterogeneity X2(2) = 3.139, non-significant). Similarly, the odds ratio from the combination of evidence from the three cervical cancer screening trials was significant (1.180, 95 percent CI: 1.020 to 1.339). The resulting odds ratio from the combination of evidence from the three tetanus immunization trials was significant (2.819, 95 percent CI: 2.664 to 2.975). The results of the meta-analyses for cervical cancer screening and tetanus immunizations indicate that physician reminders are an effective information intervention and can improve compliance for these two preventive health care procedures. Based on the results of this meta-analysis, further trials testing the effect of physician reminders on tetanus immunization would be unnecessary and probably unethical.