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Title Protocol-based computer reminders, the quality of care, and the non-perfectability of man
Author(s) Clement J. McDonald, MD
Source NEJM, Vol. 295, No. 24, Pages 1351-1355
Publication Date December 9, 1976
Abstract To determine whether clinical errors can be reduced by prospective computer suggestions about the management of simple clinical events, I studied the responses of nine physicians to computer suggestions generated by 390 protocols in a controlled crossover design. These protocols dealt primarily with conditions managed (e.g., elevated blood pressure) or caused (e.g., liver toxicity) by drugs. Physicians responded to 51 percent of 327 events when given, and 22 percent of 385 events when not given computer suggestions. Neither level of postgraduate training (first-year postgraduate or third-year postgraduate) nor the order in which physicians served as study and control subjects had statistically significant overall effect on the results. It appears that the prospective reminders do reduce errors, and that many of these errors are probably due to man's limitations as a data processor rather than to correctable human deficiencies.


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