META ANALYSIS OF CLINICAL INFORMATION SERVICE TRIALS

信息越来越被认为是一种临床干预手段，而且 日益增长的需求是提供关于阿司匹林临床疗效的受控数据 信息技术。不幸的是，很难访问 信息服务试验和量化审查的结果(元 分析)的现有证据尚未在以下领域发表 医学信息学。 本项目的目的是评估计算机的临床价值- 通过综合证据进行辅助和常规信息服务 来自随机对照临床试验。 提出了一系列的Meta分析来评价主要卫生服务的效果。 对提供者和患者行为的信息干预。这些 分析将评估(1)周期性延迟信息的效果 对临床实践模式的反馈；(2)关于医疗的警报和提醒 决策，以及(3)交互式患者教育、指导和 对健康状况进行自我治疗。此外，累积元- 分析将集中在其他几种有希望的信息干预上 包括计算机计算的预测、患者数据摘要以及 计算机辅助的药物治疗计划。在适当的情况下，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， 健康)、手动搜索(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)。 通过对初始审判报告库的评价(资格 检查，质量评级)研究将被选为荟萃分析。失明的 将应用提取方法从 报告。如有必要，将以更多形式与作者联系 信息。二元和连续效果(终点)变量将为 在表格中进行转换和汇总(赔率比、比率差异、平均值 值，t值)。将计算点数和.95区间估计值 每一项研究都是为了整体效果。统计假设检验将 检查合并研究的同质性，信息干预的效果 对比各种因素的控制和影响。 干预的临床效果。敏感性分析将评估 未发表的研究对OUR有效性的潜在修改作用 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.