N S Bauer1, A E Carroll2, C Saha3, S M Downs1. 1. Indiana University School of Medicine, Department of Pediatrics, Section of Children's Health Services Research , Indianapolis, Indiana, USA ; Regenstrief Institute for Healthcare , Indianapolis, Indiana, USA. 2. Indiana University School of Medicine , Department of Pediatrics, Section of Pediatric and Adolescent Comparative Effectiveness Research, Indianapolis, Indiana, USA ; Regenstrief Institute for Healthcare , Indianapolis, Indiana, USA. 3. Indiana University School of Medicine , Department of Biostatistics, Indianapolis, Indiana, USA.
Abstract
OBJECTIVE: To examine whether adding an autism module promoting adherence to clinical guidelines to an existing computer decision support system (CDSS) changed physician knowledge and self-reported clinical practice. METHODS: The CHICA (Child Health Improvement through Computer Automation) system, a CDSS, was enhanced with a module to improve management of autism in 2 of the 4 community pediatric clinics using the system. We examined the knowledge and beliefs of pediatric users using cross-sectional surveys administered at 3 time points (baseline, 12 months and 24 months post-implementation) between November 2010 and January 2013. Surveys measured knowledge, beliefs and self-reported practice patterns related to autism. RESULTS: A total of 45, 39, and 42 pediatricians responded at each time point, respectively, a 95-100% response rate. Respondents' knowledge of autism and perception of role for diagnosis did not vary between control and intervention groups either at baseline or any of the two post-intervention time points. At baseline, there was no difference between these groups in rates in the routine use of parent-rated screening instruments for autism. However, by 12 and 24 months post-implementation there was a significant difference between intervention and control clinics in terms of the intervention clinics consistently screening eligible patients with a validated autism tool. Physicians at all clinics reported ongoing challenges to community resources for further work-up and treatment related to autism. CONCLUSIONS: A CDSS module to improve primary care management of ASD in pediatric practice led to significant improvements in physician-reported use of validated screening tools to screen for ASDs. However it did not lead to corresponding changes in physician knowledge or attitudes.
RCT Entities:
OBJECTIVE: To examine whether adding an autism module promoting adherence to clinical guidelines to an existing computer decision support system (CDSS) changed physician knowledge and self-reported clinical practice. METHODS: The CHICA (Child Health Improvement through Computer Automation) system, a CDSS, was enhanced with a module to improve management of autism in 2 of the 4 community pediatric clinics using the system. We examined the knowledge and beliefs of pediatric users using cross-sectional surveys administered at 3 time points (baseline, 12 months and 24 months post-implementation) between November 2010 and January 2013. Surveys measured knowledge, beliefs and self-reported practice patterns related to autism. RESULTS: A total of 45, 39, and 42 pediatricians responded at each time point, respectively, a 95-100% response rate. Respondents' knowledge of autism and perception of role for diagnosis did not vary between control and intervention groups either at baseline or any of the two post-intervention time points. At baseline, there was no difference between these groups in rates in the routine use of parent-rated screening instruments for autism. However, by 12 and 24 months post-implementation there was a significant difference between intervention and control clinics in terms of the intervention clinics consistently screening eligible patients with a validated autism tool. Physicians at all clinics reported ongoing challenges to community resources for further work-up and treatment related to autism. CONCLUSIONS: A CDSS module to improve primary care management of ASD in pediatric practice led to significant improvements in physician-reported use of validated screening tools to screen for ASDs. However it did not lead to corresponding changes in physician knowledge or attitudes.
Authors: Aaron E Carroll; Paul Biondich; Vibha Anand; Tamara M Dugan; Stephen M Downs Journal: J Am Med Inform Assoc Date: 2012-06-28 Impact factor: 4.497
Authors: Andy W Steele; Sheri Eisert; Art Davidson; Taylor Sandison; Pat Lyons; Nedra Garrett; Patricia Gabow; Eduardo Ortiz Journal: Am J Prev Med Date: 2005-04 Impact factor: 5.043
Authors: Aaron E Carroll; Nerissa S Bauer; Tamara M Dugan; Vibha Anand; Chandan Saha; Stephen M Downs Journal: Pediatrics Date: 2013-08-19 Impact factor: 7.124
Authors: K Churruca; L A Ellis; J C Long; C Pomare; L K Wiles; G Arnolda; H P Ting; S Woolfenden; V Sarkozy; C de Wet; P Hibbert; J Braithwaite Journal: J Autism Dev Disord Date: 2019-12