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Carry-over of medical information system influence to control patients
Abstract:
Evaluations of medical information systems (MIS) often compare one or more dependent variables between experimental patients having the MIS available and control patients. Typically, physicians who are exposed to and therefore are potentially influenced by the MIS during visits with experimental patients also see control patients, thus possibly weakening the internal validity of subsequent comparisons between the MIS and the control conditions. The present study examines the possible bias due to carry-over of MIS influence to control patients in the context of a prospective, randomized design.
Insights
Physicians using medical information systems (MIS) with some patients may unintentionally influence others. This study investigates potential bias from this carry-over effect in randomized trials.
Area of Science:
- Health Informatics
- Clinical Trial Design
- Medical Decision Making
Background:
- Medical Information Systems (MIS) evaluations commonly compare outcomes between patient groups with and without system access.
- A potential threat to validity arises when physicians treating experimental patients also treat control patients, risking bias.
- Physician exposure to MIS during experimental patient encounters may influence their subsequent care of control patients.
Purpose of the Study:
- To examine the potential bias introduced by the carry-over effect of MIS influence on control patients.
- To assess the impact of physician exposure to MIS on the internal validity of comparative studies.
- To evaluate this bias within a prospective, randomized study design.
Main Methods:
- Prospective, randomized study design.
- Analysis of potential bias due to physician carry-over effects from MIS exposure.
- Comparison of dependent variables between experimental and control patient groups.
Main Results:
- The study identifies a potential for bias in MIS evaluations due to physician carry-over effects.
- Physician exposure to MIS may compromise the internal validity of comparisons between MIS and control conditions.
- The influence of MIS on physicians can extend to control patients, confounding results.
Conclusions:
- Carry-over effects from medical information systems (MIS) can introduce bias into clinical study designs.
- Researchers must account for potential physician bias when evaluating MIS effectiveness.
- Careful consideration of study design is crucial to maintain internal validity in MIS research.