REGISTRY AND ANALYSIS OF COMPUTER TRIALS IN PRIMARY CARE

计算机化的信息系统可以极大地改善初级卫生保健 护理服务。然而，福利索赔通常是基于 非实验证据。随机控制临床计算机 试验(RCT)可以严格评估计算机技术在 练习一下。对这些试验的回顾将提供有用的评估 这项技术的现状。不幸的是，有几个障碍 这使得对计算机RCT的审查变得困难。其中包括 种类繁多的医学和信息科学出版物 可能会出现报告、非标准描述符、索引不完整以及 提交/选择偏向于零假设。 该项目的目的是提供一个全面的数据库和 审查计算机RCT，以协助选择计算机服务 证明有能力提高病人护理的质量。 建议建立一个计算机随机对照试验数据库，以登记已发表的报告 试验、未发表的试验以及已报告的正在进行或计划进行的试验。这个 注册将遵循循序渐进的协议：1)系统地搜索 审判报告。将结合使用几种方法以确保完整性： (A)使用各种策略进行MEDLINE和其他数据库搜索，(B)Hand 检索1966年以前的精选书籍、论文引文 (C)其他非正式方法(如： 信件、电子邮件、会议)。仅关于临床试验的报道 将评估患者护理过程或结果的效果 收好了。2)检索试验报告的登记。使用特定的 资格标准关于注册的决定(纳入/排除) 在检索到的试验报告中，将生成。在不明确的情况下 我们将联系作者。已注册的报告将输入到 支持链接访问重复发表和试验的数据库 测试类似的干预措施，测量类似的结果参数，或 使用相似的研究对象。3)对报道的试验进行盲目分类 功能。考虑到常规审查的潜在偏见，a 采用盲检法对研究方法和结果进行分析 在种类繁多的计算机试验中。该程序将基于 独立评估和协商一致的发展。这项审查将 导致根据以下方法对计算机RCT进行分类 干预措施、试验地点、研究人群、治疗情况以及 审判的结果。

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 A database of computer RCTs is proposed to register published reports of trials, unpublished trials, and reported ongoing or planned trials.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.