Table 8.1. Included studies of computerized systems for ADE detection and alerts*

Study InterventionStudy Design, OutcomesResults**
Kuperman, 1999 19
Computerized alerts to physicians via paging system
Level 1, Level 1Median time until initial treatment ordered:
1 vs. 1.6 hours (p=0.003)
Median time until condition resolved:
8.4 vs. 8.9 hours (p=0.11)
Number of adverse events:
no significant difference
McDonald, 1976 21
Alerts to outpatient physicians with suggested responses to medication related events
Level 1, Level 2Physicians performed recommended testing:
36% vs. 11% (p<0.00001)
Physicians made changes in therapy:
28% vs. 13% (p<0.026)
Evans, 1994 18
Computerized monitor to detect ADEs (including drug/lab monitors and searches of nursing notes) and then computerized alerts to physicians
Level 3, Level 1Type B ADEs (allergic or idiosyncratic) and severe ADEs: 0.1 vs. 0.5 per 1000 patient-days (p<0.002)
Severe ADEs: 0.1 vs. 0.4 per 1000 patient-days (p<0.001)
Rind, 1994 20
Computerized alert system to physicians about rising serum creatinine values in patients receiving potentially nephrotoxic medications
Level 3, Level 1Serious renal impairment:
RR 0.45 (95% CI: 0.22-0.94)
Mean serum creatinine lower after an event (0.16 mg/dL lower on Day 3, p<0.01)
Dose adjusted or medication discontinued an average of 21.6 hours sooner after an event (p<0.0001)
Bradshaw, 1989 17
Computerized alerts integrated into result review and alerts by flashing light
Level 3, Level 2Response time to alert condition:
3.6 (±6.5) vs. 64.6 (±67.1) hours

* ADE indicates adverse drug event; CI, confidence interval; and RR, relative risk.

** Results reported as rates with intervention vs. control (Level 1 study designs) or after intevention vs. before intervention (Level 3 study designs).

From: 8, Computer Adverse Drug Event (ADE) Detection and Alerts

Cover of Making Health Care Safer
Making Health Care Safer: A Critical Analysis of Patient Safety Practices.
Evidence Reports/Technology Assessments, No. 43.
Shojania KG, Duncan BW, McDonald KM, et al., editors.

NCBI Bookshelf. A service of the National Library of Medicine, National Institutes of Health.