Evidence Table 34

Outcomes in studies addressing the impact of CHI applications on relationship-centered outcomes

Author, yearOutcomesControl InterventionnMeasure at BLMeasure at time point 2Measure at time point 3Measure at time point 4Measure at final time pointratios at time pointsSignificance
Breast Cancer
Green, 20051Alter content of discussionsControl105After counseling session with genetic counselor
Counseling & Interactive computer program106After counseling session with genetic counselor:1000.03
Change the way they used their timeControl105After counseling session with genetic counselor
Counseling & Interactive computer program106After counseling session with genetic counselor:100
Used time more efficientlyControl105After counseling session with genetic counselor
Counseling & Interactive computer program106After counseling session with genetic counselor:100
Skip material typically presentControl105After counseling session with genetic counselor
Counseling & Interactive computer program106After counseling session with genetic counselor:100
Effectiveness of counseling sessionControl105After counseling session with genetic counselor
Counseling & Interactive computer program106After counseling session with genetic counselor:100Final time point, 0.81 (patients) and 0.45 (counselors)
Shorter counseling sessionsControl105After counseling session with genetic counselor
Counseling & Interactive computer program106After counseling session with genetic counselorFinal time point, 0.03
Gustafson, 20082Social supportControl80Quality of life mean, 0.18 SD, 0.539 month: mean, 0.11 SD, 0.45BL, .058
.039
.126
Time point 2, .24
.004
.32
Final time point, .018
.021
.028
Internet75Quality of life mean, -0.02 SD, 0.569 month: mean, 0.07 SD, 0.45BL,.84
.39
.69
Time point 2, .44
.77
.53
Final time point, .33
.57
.48
CHESS80Quality of life mean, 0.02 SD, 0.549 month: mean, 0.18 SD, 0.54BL, .029
.003
.007
Time point 2, 0.47
.027
.15
Final time point, .14
.14
.16
Quality of lifeControl80Social support: mean, 0.23 SD, 0.494 month9 month mean, 0.13 SD, 0.54
Internet75social support: mean, -0.08 SD, 0.564 month9 month mean, 0.06 SD, 0.58
CHESS80Social support: mean, 0.16 SD, 0.494 month9 month mean, 0.21 SD, 0.55
Health competenceControl80Health and information competence mean, 0.17SD, 0.394 month9 month mean, 0.12 SD, 0.37
Internet75Health and information competence mean, -0.03SD, 0.484 month9 month mean, 0.06 SD, 0.49
CHESS80Health and information competence mean, 0.12SD, 0.474 month9 month mean, 0.18 SD, 0.48
Gustafson, 20013Information competenceControl1252 month mean, 65.65 month: mean, 65.8Time point 2, 0.01
Chess1212 month mean, 70.45 month: mean, 69.3Time point 2, 0.01
ParticipationControl1252 month mean, 74.35 monthtime point 2, 0.01
CHESS1212 month mean, 80.75 monthTime point 2, 0.01
Control1252 month mean, 74.35 monthTime point 2, 0.01
CHESS1212 month mean, 80.75 monthTime point 2, 0.01
Confidence in doctorsControl1252 month mean, 77.35 monthTime point 2, 0.05
CHESS121mean, 832 monthRR or OR time point 3, 0.055 month
Maslin, 19984Anxiety and depressionInteractive Video Disk forshared decision making51Score on HAD9 months later
519 months later
Satisfaction with treatment decisionControl519 months after diagnosis
Interactive Video Disk forshared decision making519 months after diagnosis
Caregiver decision making
Brennan, 19955Decision confidenceControl49Likert scale, 14 items, 5 choices mean, 54.65 SD, 7.312 months: mean, 54.7 SD, 6.1
ComputerLink47Likert scale 14 items, 5 choices mean, 51.9 SD, 612 months: mean, 56.8 SD, 7<.01
Improved decision making skillControl49Number of alternatives caregiver considers to solve a problem: mean, 2.51 SD, 0.9112 months mean, 2.37 SD, 78
ComputerLink47Number of alternatives caregiver considers to solve a problem: mean, 2.53 SD, 0.7812 months mean, 2.4 SD, 0.610.2
IsolationControl49Score on Instrumental and Expressive Support Scale (IESS) mean, 62.7SD, 15.512 months mean, 62.6 SD, 16
ComputerLink47mean, 63.4SD, 16.612 months mean, 65 SD, 17.40.51
HIV/AIDS
Flatley-Brennan, 19986Improved decision making confidenceControl26Mean score mean, 52.8 SD, 6Post-intervention: mean, 56.47 SD, 4.2BL, 0.05 time point 2, final time point, 0.05
Computer Link31Mean score mean, 54.35 SD, 5.9Post-intervention:mean, 51.45 SD, 6.9BL, 0.05 time point 2, final time point, 0.05
Improved decision making skill
Reduced social isolation
Control26Mean score: mean, 4.73 SD, 1.4Post-intervention mean, 5.47 SD, 1.3BL, 0.05 time point 2, final time point, 0.05
Computer Link31Mean Score: mean, 4.58 SD, 5.4Post-intervention mean, 5.4 SD, 1.5BL, 0.05 time point 2, final time point, 0.05
Control26Mean score mean, 67.05SD, 17Post-intervention mean, 68 SD, 16.8BL, 0.05 time point 2, final time point, 0.05
Computer Link31Mean score mean, 63.5SD, 14.4Post-intervention mean, 66.08 SD, 13.68BL, 0.05 time point 2, final time point, 0.05
Differential decline in health status26Mean score mean, 13.8 SD, 4.93Post-intervention mean, 13.65 SD, 1.3BL, 0.05 final time point, 0.05
Computer Link31RR or OR time point 2, 0.05Post-interventionmean, 13 SD, 1.7BL, 0.05 time point 2, No improvement over control
Arthritis
Sciamanna, 20057Patient overall satisfaction score with the osteoarthritis care they are receivingControl57One measurement only, survey before or after viewing the web-based module
www‚Äč.myexpertdoctor.com tailored feedback on quality of received care64One measurement only, survey before or after viewing the web-based module:BL, No diff between control & intervention group time point 2,final time point
Vaginal or c-section delivery
Montgomery, 20078mean (SD) on DCS at follow upUsual Care201Total score on DCS37 weeks gestation (DCS): mean, 27.8 SD, 14.6
Computerized Educational Information201Total score on DCS37 weeks gestation (DCS): mean, 22.5 SD, 13.2
Decision analysis program198Total score on DCS37 weeks gestation (DCS): mean, 23.6 SD, 15.1
Difference between groups in total score on DCS (decision v usual care)Usual Care201Difference between groups on total score on DCS(adjusted figure2 weeks post delivery (satisfaction with decision)time point 4,OR:1.42(0.94 to 2.14)37 weeks gestation (DCS) mean, −4 range,−6.5 to −1.50.22
Odds ratio for caesarean (elective and emergency) v vaginal, decision v usual careComputerized Educational Information201Odds ratio for vaginal v c section (elective and emergency) decision analysis v usual care2 weeks post delivery (satisfaction with decision)37 weeks gestation (DCS)
Decision analysis program2 weeks post delivery (satisfaction with decision)37 weeks gestation (DCS)
Usual Care2 weeks post delivery (satisfaction with decision)37 weeks gestation (DCS)
Computerized Educational Information2 weeks post delivery (satisfaction with decision)37 weeks gestation (DCS)
Satisfaction with decision (decision analysis v usual care)Decision analysis program201Satisfaction with decision as odds ratio (decision analysis v usual care)2 weeks post delivery (satisfaction with decision)37 weeks gestation (DCS) mean, 0.14 range,0.02 to 0.270.063
Mode of delivery - elective caesareanUsual Care2016 weeks post deliveryquestionnaire at 36 weeks gestationHospital records: type of delivery:50
Computerized Educational Information2016 weeks post deliveryquestionnaire at 36 weeks gestationHospital records: type of delivery:49
Decision analysis program1986 weeks post deliveryquestionnaire at 36 weeks gestationHospital records: type of delivery:41
Delivery - emergency caesareanUsual Care2386 weeks post deliveryquestionnaire at 36 weeks gestationHospital records: type of delivery:20
Computerized Educational Information2406 weeks post deliveryquestionnaire at 36 weeks gestationHospital records: type of delivery:22
Decision analysis program2356 weeks post deliveryquestionnaire at 36 weeks gestationHospital records: type of delivery:21
Delivery - vaginal birthUsual Care2386 weeks post deliveryquestionnaire at 36 weeks gestationHospital records: type of delivery:30
Computerized Educational Information2406 weeks post deliveryquestionnaire at 36 weeks gestationHospital records: type of delivery:29
Decision analysis program2356 weeks post deliveryquestionnaire at 36 weeks gestationHospital records: type of delivery:37

BL = baseline, SD = standard deviation, OR = odd ratio, RR = relative ratio, DCS = decisional conflict scale

Reference List

1

Green MJ, Peterson SK, Baker MW et al. Use of an educational computer program before genetic counseling for breast cancer susceptibility: effects on duration and content of counseling sessions. Genet Med 2005; 7(4):221–9.

2

Gustafson DH, Hawkins R, Mctavish F et al. Internet-based interactive support for cancer patients: Are integrated systems better? 2008; 58(2):238–57.

3

Gustafson DH, Hawkins R, Pingree S et al. Effect of computer support on younger women with breast cancer. J Gen Intern Med 2001; 16(7):435–45.

4

Maslin AM, Baum M, Walker JS, A'Hern R, Prouse A. Using an interactive video disk in breast cancer patient support. Nurs Times 1998; 94(44):52–5.

5

Brennan PF, Moore SM, Smyth KA. The effects of a special computer network on caregivers of persons with Alzheimer's disease. Nurs Res 1995; 44(3):166–72.

6

Flatley-Brennan P. Computer network home care demonstration: a randomized trial in persons living with AIDS. Comput Biol Med 1998; 28(5):489–508.

7

Sciamanna CN, Harrold LR, Manocchia M, Walker NJ, Mui S. The effect of web-based, personalized, osteoarthritis quality improvement feedback on patient satisfaction with osteoarthritis care. Am J Med Qual 2005; 20(3):127–37.

8

Montgomery AA, Emmett CL, Fahey T et al. Two decision aids for mode of delivery among women with previous caesarean section: randomised controlled trial. BMJ 2007; 334(7607):1305.

Green MJ, Peterson SK, Baker MW et al. Use of an educational computer program before genetic counseling for breast cancer susceptibility: effects on duration and content of counseling sessions. Genet Med 2005; 7(4):221–9.

Gustafson DH, Hawkins R, Mctavish F et al. Internet-based interactive support for cancer patients: Are integrated systems better? 2008; 58(2):238–57.

Gustafson DH, Hawkins R, Pingree S et al. Effect of computer support on younger women with breast cancer. J Gen Intern Med 2001; 16(7):435–45.

Maslin AM, Baum M, Walker JS, A'Hern R, Prouse A. Using an interactive video disk in breast cancer patient support. Nurs Times 1998; 94(44):52–5.

Brennan PF, Moore SM, Smyth KA. The effects of a special computer network on caregivers of persons with Alzheimer's disease. Nurs Res 1995; 44(3):166–72.

Flatley-Brennan P. Computer network home care demonstration: a randomized trial in persons living with AIDS. Comput Biol Med 1998; 28(5):489–508.

Sciamanna CN, Harrold LR, Manocchia M, Walker NJ, Mui S. The effect of web-based, personalized, osteoarthritis quality improvement feedback on patient satisfaction with osteoarthritis care. Am J Med Qual 2005; 20(3):127–37.

Montgomery AA, Emmett CL, Fahey T et al. Two decision aids for mode of delivery among women with previous caesarean section: randomised controlled trial. BMJ 2007; 334(7607):1305.

From: Appendix G

Cover of Impact of Consumer Health Informatics Applications
Impact of Consumer Health Informatics Applications.
Evidence Reports/Technology Assessments, No. 188.
Gibbons MC, Wilson RF, Samal L, et al.

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