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Efficacy of computerized decision support for mechanical ventilation: results of a prospective multi-center randomized trial.

East, TD and Heermann, LK and Bradshaw, RL and Lugo, A and Sailors, RM and Ershler, L and Wallace, CJ and Morris, AH and McKinley, B and Marquez, A and Tonnesen, A and Parmley, L and Shoemaker, W and Meade, P and Thaut, P and Hill, T and Young, M and Baughman, J and Olterman, M and Gooder, V and Quinn, B and Summer, W and Valentine, V and Carlson, J and Steinberg, K (1999) Efficacy of computerized decision support for mechanical ventilation: results of a prospective multi-center randomized trial. Proc AMIA Symp. 251 - 255. ISSN 1531-605X

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Abstract

200 adult respiratory distress syndrome patients were included in a prospective multicenter randomized trial to determine the efficacy of computerized decision support. The study was done in 10 medical centers across the United States. There was no significant difference in survival between the two treatment groups (mean 2 = 0.49 p = 0.49) or in ICU length of stay between the two treatment groups when controlling for survival (F(1df) = 0.88, p = 0.37.) There was a significant reduction in morbidity as measured by multi-organ dysfunction score in the protocol group (F(1df) = 4.1, p = 0.04) as well as significantly lower incidence and severity of overdistension lung injury (F(1df) = 45.2, p < 0.001). We rejected the null hypothesis. Efficacy was best for the protocol group. Protocols were used for 32,055 hours (15 staff person years, 3.7 patient years or 1335 patient days). Protocols were active 96% of the time. 38,546 instructions were generated. 94% were followed. This study indicates that care using a computerized decision support system for ventilator management can be effectively transferred to many different clinical settings and significantly improve patient morbidity.


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Details

Item Type: Article
Status: Published
Creators/Authors:
CreatorsEmailPitt UsernameORCID
East, TD
Heermann, LK
Bradshaw, RL
Lugo, A
Sailors, RM
Ershler, L
Wallace, CJ
Morris, AH
McKinley, B
Marquez, A
Tonnesen, A
Parmley, L
Shoemaker, W
Meade, P
Thaut, P
Hill, T
Young, M
Baughman, J
Olterman, M
Gooder, V
Quinn, B
Summer, W
Valentine, V
Carlson, J
Steinberg, K
Date: 1999
Date Type: Publication
Journal or Publication Title: Proc AMIA Symp
Page Range: 251 - 255
Event Type: Conference
Schools and Programs: School of Medicine > Critical Care Medicine
Refereed: Yes
Uncontrolled Keywords: Adult, Clinical Protocols, Decision Support Systems, Clinical, Humans, Prospective Studies, Respiration, Artificial, Respiratory Distress Syndrome, Survival Analysis, Therapy, Computer-Assisted
ISSN: 1531-605X
PubMed Central ID: PMC2232746
PubMed ID: 10566359
Date Deposited: 22 Mar 2012 20:52
Last Modified: 19 Dec 2020 22:56
URI: http://d-scholarship.pitt.edu/id/eprint/11395

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