Assessment of Health Information Technology Interventions in Evidence-Based Medicine: A Systematic Review by Adopting a Methodological Evaluation Framework (original) (raw)
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Evidence-based health and clinical informatics: a systematic review on randomized controlled trials
Health and Technology, 2017
Towards the provision of medical research and eHealth services, several Health Information Technology (HIT) platforms are blended with communication and software technologies (i.e. mobile and Web applications, wireless sensor networks, Internet of Things and cloud computing). However, an important research issue is whether and to what degree these technologies are efficiently and effectively integrated into medical practice. Accordingly, this study reviews recent literature on HITs that employ RCTs, which are acknowledged as a reliable solution by the community of health stakeholders. Furthermore, it examines the research efforts in the field and evaluates the relevant functionalities. The literature search strategy was based on PRISMA 2009 Checklist and the CONSORT-EHEALTH Checklist that are two standard methodologies for systematic reviews in Evidence Based Medicine and Health Information Technologies. The analysis of the studies included was performed according to the Cochrane Risk of Bias Assessment Tool. The sources considered in this research include the most common clinical trial registries and academic electronic databases. The studies considered were conducted from 2008 until 2016. The authors considered RCTs having published their results in at least one article. As a result, 55 articles from 42 different journals are considered in this review. The benefits of the HIT delivered interventions are clearly presented in the outcomes of the relevant studies. Significant improvements were observed in the findings of 31 trials from a total of 51 (60.78%) including the acceptance, satisfaction, reliability, usefulness, safety, effectiveness and financial benefit of HITs. The results of this review reveal that HIT and eHealth interventions achieve at least equally reliable and safe outcomes compared with the usual support methods of healthcare. Significantly encouraging results are noticed in interventions employing HIT over several healthcare fields.
Clinical Trials, 2013
Background Despite the proliferation of health information technology (IT) interventions, descriptions of the unique considerations for conducting randomized trials of health IT interventions intended for patient use are lacking. Purpose Our purpose is to describe the protocol to evaluate Pocket PATH® (Personal Assistant for Tracking Health), a novel health IT intervention, as an exemplar of how to address issues that may be unique to a randomized controlled trial (RCT) to evaluate health IT intended for patient use. Methods An overview of the study protocol is presented. Unique considerations for health IT intervention trials and strategies are described to maintain equipoise, to monitor data safety and intervention fidelity, and to keep pace with changing technology during such trials. Lessons Learned The sovereignty granted to technology, the rapid pace of changes in technology, ubiquitous use in health care, and obligation to maintain the safety of research participants challeng...
Vision and challenges of Evidence-Based Health Informatics: A case study of a CPOE meta-analysis
International Journal of Medical Informatics, 2010
Objective: To discuss, taking the example of a meta-analysis on computerized physician order entry (CPOE) systems, the special challenges of Evidence-Based Health Informatics, defined as the conscientious, explicit and judicious use of current best evidence when making decisions about introduction and operation of information technology in a given health care setting.
Journal of the American Medical Informatics Association, 2007
A b s t r a c t Concerned about evidence-based health informatics, the authors conducted a limited pilot survey attempting to determine how many IT evaluation studies in health care are never published, and why. A survey distributed to 722 academics had a low response rate, with 136 respondents giving instructive comments on 217 evaluation studies. Of those studies, half were published in international journals, and more than one-third were never published. Reasons for not publishing (with multiple reasons per study possible) included: "results not of interest for others" (1/3 of all studies), "publication in preparation" (1/3), "no time for publication" (1/5), "limited scientific quality of study" (1/6), "political or legal reasons" (1/7), and "study only conducted for internal use" (1/8). Those reasons for non-publication in health informatics resembled those reported in other fields. Publication bias (preference for positive studies) did not appear to be a major issue. The authors believe that widespread application of guidelines in conducting health informatics evaluation studies and utilization of a registry for evaluation study results could improve the evidence base of the field. Ⅲ J Am Med Inform Assoc.
Health Information Management Journal, 2009
The aim of this study was to systematically review the published evidence of the impact of health information technology (HIT) or health information systems (HIS) on the quality of healthcare, focusing on clinicians' adherence to evidence-based guidelines and the corresponding impact this had on patient clinical outcomes. The review covered the use of health information technologies and systems in both medical care (i.e. clinical and surgical) and other areas such as allied health and preventive services. Studies were included in the review if they examined the impact of Electronic Health Record (EHR), Computerised Provider Order-Entry (CPOE), or Decision Support System (DS); and if the primary outcomes of the studies were focused on the level of compliance with evidence-based guidelines among clinicians. Measurements considered relevant to the review were either of changes in clinical processes resulting from a change of the providers' behaviour, or of specific patient outc...
Information systems: the key to evidence-based health practice
Bulletin of the World Health Organization, 2000
Increasing prominence is being given to the use of best current evidence in clinical practice and health services and programme management decision-making. The role of information in evidence-based practice (EBP) is discussed, together with questions of how advanced information systems and technology (IS&T) can contribute to the establishment of a broader perspective for EBP. The author examines the development, validation and use of a variety of sources of evidence and knowledge that go beyond the well-established paradigm of research, clinical trials, and systematic literature review. Opportunities and challenges in the implementation and use of IS&T and knowledge management tools are examined for six application areas: reference databases, contextual data, clinical data repositories, administrative data repositories, decision support software, and Internet-based interactive health information and communication. Computerized and telecommunications applications that support EBP follow a hierarchy in which systems, tasks and complexity range from reference retrieval and the processing of relatively routine transactions, to complex "data mining" and rule-driven decision support systems.
Evidence Based Health Informatics: 10 Years of Efforts to Promote the Principle
Yearbook of Medical Informatics
Summary Objectives: To present the importance of Evidence-based Health Informatics (EBHI) and the ethical imperative of this approach; to highlight the work of the IMIA Working Group on Technology Assessment and Quality Improvement and the EFMI Working Group on Assessment of Health Information Systems; and to introduce the further important evaluation and evidence aspects being addressed. Methods: Reviews of IMIA, EFMA and other initiatives, together with literature reviews on evaluation methods and on published systematic reviews. Results: Presentation of the rationale for the health informatics domain to adopt a scientific approach by assessing impact, avoiding harm, and empirically demonstrating benefit and best use; reporting of the origins and rationale of the IMIA- and EQUATOR-endorsed Statement on Reporting of Evaluation Studies in Health Informatics (STARE-HI) and of the IMIA WG's Guideline for Good Evaluation Practice in Health Informatics (GEP-HI); presentation of othe...
Evidence-based practice for mere mortals: the role of informatics and health services research
Journal of General Internal Medicine, 2002
The poor translation of evidence into practice is a well-known problem. Hopes are high that information technology can help make evidence-based practice feasible for mere mortal physicians. In this paper, we draw upon the methods and perspectives of clinical practice, medical informatics, and health services research to analyze the gap between evidence and action, and to argue that computing systems for bridging this gap should incorporate both informatics and health services research expertise. We discuss 2 illustrative systems Ð trial banks and a web-based system to develop and disseminate evidence-based guidelines (ALCHEMIST) Ð and conclude with a research and training agenda.
Methodologic Issues in Health Informatics Trials: The Complexities of Complex Interventions
Journal of the American Medical Informatics Association, 2008
A b s t r a c t Objective: All electronic health (e-health) interventions require validation as health information technologies, ideally in randomized controlled trial settings. However, as with other types of complex interventions involving various active components and multiple targets, health informatics trials often experience problems of design, methodology, or analysis that can influence the results and acceptance of the research. Our objective was to review selected key methodologic issues in conducting and reporting randomized controlled trials in health informatics, provide examples from a recent study, and present practical recommendations.