META ANALYSIS OF CLINICAL INFORMATION SERVICE TRIALS

信息越来越被认为是一种临床干预， 越来越多的人需要提供关于药物临床效果的受控数据， 信息技术. 不幸的是，很难进入 结果的信息服务试验和定量审查（Meta， 现有证据的分析）尚未在 医疗信息学. 本项目的目的是评估计算机- 通过综合证据提供辅助和常规信息服务 来自随机对照临床试验。 一系列的荟萃分析，提出了评估的影响，主要是 对提供者和患者的行为进行信息干预。 这些 分析将评估（1）定期延迟信息的影响 临床实践模式的反馈，（2）医疗警报和提醒 决策，和（3）互动的病人教育，指导，和 对健康状况的自我管理疗法。 此外，累积Meta- 分析将重点关注其他几项有希望的信息干预措施 包括计算机计算的预测，患者数据的总结， 计算机辅助药物治疗计划。 适当时，计算机 系统将与传统的信息服务进行比较。 将进行广泛和系统的搜索，以收集所有相关的 试验报告：书目数据库检索（例如，MEDLINE，CINAHL， 卫生），人工检索（未编入索引的出版物，参考文献列表）， 扩展干预搜索和非正式联系（专家、评审员）。 通过评价初步试验报告汇总（合格性 检查，质量评级）研究将被选中进行荟萃分析。 盲 将采用提取方法从 报道 如有必要，作者将联系形式更多 信息. 二元和连续效应（终点）变量将 转换并汇总于表格中（比值比、率差、平均值 值，t值）。 将计算点和.95区间估计值， 每项研究和整体效果。 统计假设检验将 检查汇总研究的同质性，信息干预的效果 与对照组相比， 干预的临床效果。 敏感性分析将评估 未发表的研究对我们的有效性的潜在修改效果 结论.

Information is increasingly recognized as a clinical intervention and there is a growing demand to provide controlled data on the clinical effect of information technology. Unfortunately, it is difficult to access the results of information service trials and quantitative reviews (meta- analyses) of the available evidence have not been published in the area of medical informatics. The purpose of this project is to assess the clinical value of computer- assisted and conventional information services by synthesizing evidence from randomized controlled clinical trials. A series of meta-analyses is proposed to evaluate the effect of major information interventions on the behavior of providers and patients. These analyses will evaluate the effect of (1) periodic delayed information feedback on clinical practice patterns, (2) alerts and reminders on medical decision-making, and (3) interactive patient education, instruction, and self-administered therapy on health status. In addition, cumulative meta- analyses will focus on several other promising information interventions including computer-calculated prediction, summaries of patient data, and computer-assisted planning of drug treatment. When appropriate, computer systems will be compared with conventional information services. Extensive and systematic searches will be performed to collect all relevant trial reports: bibliographic database retrievals (e.g., MEDLINE, CINAHL, HEALTH), manual searches (unindexed publications, reference lists), extended intervention searches, and informal contacts (experts, reviewers). Through the evaluation of the initial pool of trial reports (eligibility check, quality rating) studies will be selected for meta-analysis. Blinded extraction method will be applied to obtain the necessary data from the reports. If necessary, the authors will be contacted form more information. Binary and continuous effect (end-point) variables will be transformed and summarized in tables (odds ratio, rate difference, mean value, t value). Point and .95 interval estimates will be calculated for each study and for the overall effect. Statistical hypothesis testing will check homogeneity of the pooled studies, effect of information intervention in comparison to the control, and influence of various factors on the clinical effect of the intervention. Sensitivity analysis will assess the potential modifying effect of unpublished studies on the validity of our conclusions.