Table 2:

Characteristics of randomized controlled trials supported by electronic health records

InvestigatorCountry; sample sizeEHR use for recruitment; study typeEHR use for outcome assessment; extent of use of routinely collected dataPatient population/ indicationIntervention and control*Primary outcome; length of follow-up; amount of missing dataSetting
Bereznicki et al.,18 2008Australia; 1551 patientsYes; retrospectiveYes; EHR aloneUncontrolled asthmaIntervention: contact by community pharmacist plus educational material and referral to general practitioner for asthma managementRatio of dispensed preventer and reliever medication; 6 mo; NRCommunity pharmacy network
Corson et al.,19 2011US; 42 caregivers (randomly allocated), 365 patientsNo; prospectiveYes; hybrid, primary outcome EHR aloneMusculoskeletal painIntervention: patient and clinician education, symptom monitoring and feedback to cliniciansGuideline-concordant care; 12 mo; NRPrimary care clinics associated with Department of Veterans Affairs medical centre and urban hospital
de Jong et al.,20 2013Netherlands; 73 general practitioner trainees (randomly allocated)Yes; retrospectiveYes; hybrid, primary outcome EHR aloneSkin and psychosocial conditionsSteering patient mix of general practitioner traineesTrainee exposure to specific field, and knowledge and self-efficacy; 6 mo; 5%–10%Practice network with general practitioner training program
Fu et al.,21 2014US; 6400 patientsYes; retrospectiveYes, hybrid; primary outcome active data collection aloneCurrent smokersProactive outreach plus choice of smoking cessation services6-mo prolonged smoking abstinence at 1 yr; 12 mo; 48.3% (but 0% for EHR outcome)Department of Veterans Affairs medical centre
Galbreath et al.,22 2004US; 1069 patientsYes; retrospectiveYes, hybrid; primary outcome active data collection aloneSymptomatic congestive heart failureCongestive heart failure management program (plus at-home scale)All-cause mortality and use of health care services; NR (time to event); NRVarious health care networks and Medicare/ Medicaid participants
Gerber et al.,23 2013US; 18 practices, 170 caregivers (randomly allocated), 185 212 patientsYes; retrospectiveYes, hybrid; primary outcome active data collection aloneClinical practice groups with primary care pediatricians (children with acute respiratory tract infections)Antibiotic stewardship programChange in broad-spectrum antibiotics prescribed for bacterial infections or in antibiotic prescribed for viral infections; 12 mo; 5% of caregiversPediatric primary care network
Green et al.,24 2013US; 4675 patientsYes; retrospectiveYes; EHR alonePrevention of colorectal cancerAutomated interventions v. assisted care v. navigated care v. usual careReceiving any colorectal cancer test and being current for colorectal cancer testing in years 1 and 2; 24 mo; 0.2%Primary care practice network
Hoffman et al.,25 2010US; 404 patientsYes; retrospectiveNo; active data collection alonePrevention of colorectal cancerFecal immunochemical test (v. guaiac-based occult blood test)Screening adherence; 3 mo; NRDepartment of Veterans Affairs network (primary care clinics and laboratory)
Israel et al.,26 2013US; 732 patientsYes, retrospectiveNo; active data collection aloneAdult inpatients with at least 1 of several cardiovascular disease diagnoses in EHRMinimal intervention (medication reconciliation), enhanced intervention (minimal intervention plus pharmacist) or usual careRate of underuse of cardiovascular drugs; 3 mo; NRUniversity hospital (orthopedic, internal medicine, family medicine and cardiology wards)
McCarren et al.,27 2013US; 12 practices (randomly allocated), 220 patientsYes; retrospectiveYes; EHR aloneHeart failure and guideline-nonconcordant β-blocker prescriptionInformation to pharmacy about prescription nonconcordanceGuideline-concordant prescriptions; 6 mo; 0%Veterans Health Administration facilities and pharmacies
Phillips et al.,29 2011US; 3895 patientsYes; retrospectiveYes; EHR alonePrevention of breast cancerTelephone calls and reminder letters from patient navigatorsAdherence to biennial mammography; 9 mo; NRHospital-based internal medicine practices
Piazza et al.,30 2013US; 2513 patientsYes; retrospectiveYes; EHR aloneMedical service inpatients at risk for venous thromboembolism with planned discharge within 48 hAlert for physicianSymptomatic deep vein thrombosis or pulmonary embolism; 3 mo; < 0.1%Inpatient medical unit
Qureshi et al.,31 2012UK; 24 caregivers (randomly allocated), 748 patientsNo; prospectiveYes; hybrid, primary outcome EHR aloneAdult primary care patients with no previously diagnosed cardiovascular riskFamily history questionnaire (in addition to Framingham risk score)Proportion of identified participants with high cardiovascular risk scores; NA; 1.7%Family practices in research network
Skinner et al.,32 2015US; 1032 patientsYes; retrospectiveYes; EHR alonePrevention of colorectal cancerTablet-based Cancer Risk Intake System assessment before appointment and control groupReceived risk-appropriate colorectal cancer testing and any type of colorectal cancer testing; 12 mo; 0%Family practices affiliated with university medical centre
Stewart et al.,28 2014US; 235 patientsYes; retrospectiveYes; hybrid, primary outcome EHR aloneDysthymia or major depressive disorderCollaborative care program with psychotherapy and antidepressant drugsCardiovascular events; 96 mo; 0%Academic group practice
Vestbo et al.,33 2016UK; 2802 patientsNo; prospectiveYes; hybrid, primary outcome active data collection aloneCOPD and regular maintenance inhaler therapyFluticasone furoate + vilanterol (100 μg/ 25 μg) once a day via inhalation v. usual careModerate or severe COPD exacerbation; 12 mo; 24.8%Health care network in and around Salford, hospitals, general practitioners, pharmacies
Wolf et al.,34 2005US; 113 health care providers (randomly allocated), 1978 patientsYes; retrospectiveYes; EHR alonePrevention of colorectal cancerEducation session plus performance feedbackCompletion of colorectal cancer screening; NA; NRDepartment of Veterans Affairs primary care clinics
  • Note: COPD = chronic obstructive pulmonary disease, EHR = electronic health record, NA = not applicable, NR = not reported.

  • * All comparisons are “usual care” unless otherwise specified.

  • Number of patients not reported.

  • University of Texas Health Science Center at San Antonio, in partnership with Wilford Hall Medical Center, Brooke Army Medical Center, South Texas Veterans Health Care System, TRICARE Region 6 and University Health System.