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A Critical Appraisal

R. Brian Haynes, MD, PhD; Cynthia J. Walker, MLS

Arch Intern Med. 1987;147(7):1297-1301.

Abstract
• Computerized information systems hold the promise of overcoming problems in the management of clinical information. Many of the claims of the creators and promoters of these systems, however, are not based on sound clinical studies. To determine the ability of computer information systems to improve the quality of medical care, we applied methodologic criteria to published articles in the field. Only 30 (22%) of 135 articles reported preplanned investigations, and only half of these met minimal criteria for scientific investigations. Fourteen studies were well designed and executed. All studies reported improvements in the process of care. However, patient outcomes were not measured, not affected, or only minimally influenced. While computer information systems show increasing potential, more work is required to enhance their effect on the quality of care and thus on patient outcomes.

(Arch Intern Med 1987;147:1297-1301)

Author Affiliations
From the Department of Clinical Epidemiology and Biostatistics (Dr Haynes and Ms Walker) and the Department of Medicine (Dr Haynes), Faculty of Health Sciences, McMaster University, Hamilton, Ontario.

Footnotes
Accepted for publication Nov 26, 1986.

Reprints not available.

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