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OBJECTIVE We developed AsthmaCritic, a non-inquisitive critiquing system integrated with the general practitioners' electronic medical records. The system is based on the guidelines for asthma and chronic obstructive pulmonary disease (COPD) as issued by the Dutch College of General Practitioners. This paper assesses the effect of AsthmaCritic on monitoring(More)
Researchers claim that data in electronic patient records can be used for a variety of purposes including individual patient care, management, and resource planning for scientific research. Our objective in the project Integrated Primary Care Information (IPCI) was to assess whether the electronic patient records of Dutch general practitioners contain(More)
BACKGROUND Different methods for changing blood test-ordering behavior in primary care have been proven effective. However, randomized trials comparing these methods are lacking. OBJECTIVE To compare the effect of two versions of BloodLink, a computer-based clinical decision support system, on blood test ordering among general practitioners. DESIGN(More)
BACKGROUND The economic consequences of interventions to promote rational, evidence-based use of laboratory tests by physicians are not yet fully understood. We evaluated the cost consequences of a computer-based, guideline-driven decision-support system (CDSS) for ordering blood tests in primary care. METHODS We installed the CDSS in 118 practices [159(More)
OBJECTIVE Many studies have shown differences between statins based on surrogate endpoints, but few have studied differences in reaching clinical endpoints. This study compares the risk of cardiovascular and cerebrovascular events between atorvastatin users and other statin users in daily general practice. RESEARCH DESIGN AND METHODS A cohort study was(More)
BACKGROUND Acute urinary retention (AUR) is characterized by the sudden inability to urinate, which is usually extremely painful and requires catheterization. Prostaglandins play an important role in the genitourinary function as they provoke contractions of the detrusor muscle. Relaxation of the detrusor muscle, via the inhibition of the prostaglandin(More)
BACKGROUND Guidelines are viewed as a mechanism for disseminating a rapidly increasing body of knowledge. We determined the compliance of Dutch general practitioners with the recommendations for blood test ordering as defined in the guidelines of the Dutch College of General Practitioners. METHODS We performed an audit of guideline compliance over a(More)
BACKGROUND Indirect evidence shows that alerting users with clinical decision support systems seems to change behavior more than requiring users to actively initiate the system. However, randomized trials comparing these methods in a clinical setting are lacking. We studied the effect of both alerting and on-demand decision support with respect to screening(More)
OBJECTIVE To describe the incidence of acute urinary retention (AUR) in the general male population and in a population of men newly diagnosed with lower urinary tract symptoms suggestive of BPH (LUTS/BPH). METHODS We performed a retrospective cohort study in the Integrated Primary Care Information (IPCI) database, a GP research database in The(More)
The noninquisitive critiquing system, AsthmaCritic, uses routinely recorded electronic patient data to select and analyze records of patients with asthma or chronic obstructive pulmonary disease (COPD). The system generates critiquing comments and adds these comments to the patient record. The system was developed by using and expanding an existing generic(More)