ELMO: Evidenzbasierte Entscheidungshilfe zur Verordnung von

Zusammenfassung (Niederländisch oder Französisch oder Englisch)

Veröffentlicht auf

23.11.2017

Results (lay language)
Almost 10 000 patients were included in the study by 270 GPs. In the control arm (i.e. GPs not using a clinical decision support system - CDSS), the percentage of appropriate lab tests was 38%. CDSS increased the proportion of appropriate tests by 21% (this was statistically significant) for all tests included in the study. GPs in the CDSS arm ordered 7 tests fewer per panel (the GPs in the control arm ordered 31 tests per panel whereas GPs in the CDSS arm ordered 24 tests per panel). CDSS did not increase diagnostic error: the absolute difference in proportions between the two groups was a very small decrease (<1%) in possible diagnostic error. In conclusion, a CDSS in the form of order sets, integrated within the computerized physician order entry (CPOE) improved appropriateness and decreased volume of laboratory test ordering without increasing diagnostic error. Results expressed in scientific language can be found in the “DOCUMENTS” section.

Results (lay language)

Almost 10 000 patients were included in the study by 270 GPs.

In the control arm (i.e. GPs not using a clinical decision support system - CDSS), the percentage of appropriate lab tests was 38%. CDSS increased the proportion of appropriate tests by 21% (this was statistically significant) for all tests included in the study. GPs in the CDSS arm ordered 7 tests fewer per panel (the GPs in the control arm ordered 31 tests per panel whereas GPs in the CDSS arm ordered 24 tests per panel). CDSS did not increase diagnostic error: the absolute difference in proportions between the two groups was a very small decrease (<1%) in possible diagnostic error.

In conclusion, a CDSS in the form of order sets, integrated within the computerized physician order entry (CPOE) improved appropriateness and decreased volume of laboratory test ordering without increasing diagnostic error.

Results expressed in scientific language can be found in the “DOCUMENTS” section.

TRIAL DESCRIPTION

Title	The effect of evidence-based order sets within a CPOE (computerised physician order entry) system on the quantity and quality of laboratory test ordering in family practice: a cluster randomised trial (KCE-16011)
Participants (P)	Patients from primary care physicians (GPs) affiliated to one of three collaborating laboratories in the Leuven, Ghent or Antwerp regions
Intervention (I)	Evidence-based order sets for laboratory tests based on indication, implemented within a computerised physician order entry (CPOE) system
Control (C)	CPOE without evidence-based laboratory test order sets
Outcome (O)	Percentage of appropriate laboratory tests, volume of tests ordered, percentage of missed diagnoses.
Trial Design	Cluster randomised controlled trial
Sample Size	300 physicians randomized, data collected for 12 000 patients
Trial duration	2 years
Budget	1.8 million € (incl. VAT)

TRIAL TEAM

Sponsor	UZ Leuven – KU Leuven
Chief Investigator	Prof Dr Bert Aertgeerts, Academic Center for General Practice, KU Leuven
Trial coordinator	Dr Nicolas Delvaux, Academic Center for General Practice, KU Leuven
External Partners	Prof Dr An De Sutter, Department of Family Medicine and Primary Health Care, Ghent University
	Healthdata.be, Scientific Institute of Public Health
	Laboratory Anacura, Evergem
	Medisch Centrum Huisartsen (MCH), Leuven
	Algemeen Medisch Labo (AML), Antwerpen