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Proc Annu Symp Comput Appl Med Care. 1995 : 576–580.
PMCID: PMC2579159

The impact of a guideline-driven computer charting system on the emergency care of patients with acute low back pain.


Federal guidelines for the treatment of acute low back pain were locally modified and made more specific. These guidelines were then programmed into a rule-based computer charting system which provides real-time advice regarding documentation, testing, treatment, and disposition of emergency department patients with this condition. In a time-series off-on experiment the system was shown to significantly improve documentation of the medical record and discharge instructions. There was little effect on the appropriateness of testing and treatment and the cost of care. These findings contrast with our previous experiment using a similar program for the care of health care workers exposed to body fluids. In that study both the appropriateness of care and the cost-effectiveness of care were substantially improved.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.
  • McDonald CJ, Wilson GA, McCabe GP., Jr Physician response to computer reminders. JAMA. 1980 Oct 3;244(14):1579–1581. [PubMed]
  • Wilson GA, McDonald CJ, McCabe GP., Jr The effect of immediate access to a computerized medical record on physician test ordering: a controlled clinical trial in the emergency room. Am J Public Health. 1982 Jul;72(7):698–702. [PubMed]
  • Soumerai SB, Avorn J. Principles of educational outreach ('academic detailing') to improve clinical decision making. JAMA. 1990 Jan 26;263(4):549–556. [PubMed]
  • Lomas J, Enkin M, Anderson GM, Hannah WJ, Vayda E, Singer J. Opinion leaders vs audit and feedback to implement practice guidelines. Delivery after previous cesarean section. JAMA. 1991 May 1;265(17):2202–2207. [PubMed]

Articles from Proceedings of the Annual Symposium on Computer Application in Medical Care are provided here courtesy of American Medical Informatics Association