Cochrane · systematic review · CD002894
Computerized advice on drug dosage to improve prescribing practice
Gillaizeau, F, Chan, E, Trinquart, L, et al. · Cochrane Database of Systematic Reviews · 2013 · Cochrane Library
Effective Practice and Organisation of CareAMSTAR 2: not assessed
SoF tableOnly the outcomes this review put in its Summary of Findings table are listed (the Cochrane Handbook caps them at about seven per comparison). Its other analyses are not shown here.
Questions
21
current version
GRADE rated
21
No studies
0
Included studies
NR
No studies 0 · 0%Ungraded 0 · 0%Very low 7 · 33.3%Low 9 · 42.9%Moderate 4 · 19%High 1 · 4.8%
Ungraded means an effect was reported without a GRADE rating; it is not a gap. No studies means the review found nothing to answer the question. The six categories are a display order, not a score.
Questions and results
Computerized advice on drug dosage for leading serum concentrations within therapeutic range
Population: patients with leading serum concentrations within therapeutic range
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Serum concentrations ‐ aminoglycoside antibiotics: peak concentration | no estimate extracted | 4 studies · 372 participants | Low Downgraded: risk of bias, imprecision, publication bias |
Serum concentrations ‐ theophylline | no estimate extracted | 4 studies · 201 participants | Low Downgraded: risk of bias, imprecision, publication bias |
Proportion of participants within therapeutic range ‐ aminoglycoside antibiotics: % of participants with peak concentrations adequate after 2 days | RR 4.44 [1.94, 10.13] | 2 studies · 72 participants | Moderate Downgraded: risk of bias, imprecision, publication bias |
Proportion of participants with toxic drug levels ‐ theophylline | RR 0.53 [0.25, 1.13] | 2 studies · 109 participants | Moderate Downgraded: risk of bias, imprecision, publication bias |
Computerized advice on drug dosage for leading physiological parameters within therapeutic range
Population: patients with leading physiological parameters within therapeutic range
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Oral anticoagulants: time in target INR range (%) | no estimate extracted | 6 studies · 13581 participants | Very low Downgraded: risk of bias, publication bias |
Insulin: time in target glucose range (%) | no estimate extracted | 4 studies · 234 participants | Low Downgraded: risk of bias, publication bias |
Computerized advice on drug dosage for reducing time to achieve therapeutic control
Population: patients with reducing time to achieve therapeutic control
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Time to achieve therapeutic range ‐ oral anticoagulants: time to achieve therapeutic prothrombin ratio (days) | no estimate extracted | 2 studies · 223 participants | Low Downgraded: risk of bias, imprecision, publication bias |
Time to achieve therapeutic range ‐ insulin: time to achieve therapeutic control (hours) | no estimate extracted | 4 studies · 194 participants | Very low Downgraded: risk of bias, imprecision, publication bias |
Time to stabilization ‐ oral anticoagulants: time to stabilization (days) | no estimate extracted | 3 studies · 255 participants | Very low Downgraded: risk of bias, imprecision, publication bias |
Computerized advice on drug dosage for leading to fewer clinical adverse events
Population: patients with leading to fewer clinical adverse events
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Death | RR 1.08 [0.8, 1.45] | 10 studies · 14046 participants | Low Downgraded: risk of bias, publication bias |
Anticoagulants: events ‐ bleeding | RR 0.65 [0.3, 1.41] | 6 studies · 552 participants | Low Downgraded: risk of bias, publication bias |
Anticoagulants: events ‐ thromboembolism | RR 3.25 [0.66, 16.03] | 4 studies · 355 participants | Very low Downgraded: risk of bias, imprecision, publication bias |
Insulin ‐ hypoglycaemia (< 60 mg/dL) | RR 0.71 [0.35, 1.48] | 7 studies · 378 participants | Low Downgraded: risk of bias, imprecision, publication bias |
Insulin ‐ severe hypoglycaemia (< 40 mg/dL) | RR 0.69 [0.11, 4.31] | 4 studies · 292 participants | Very low Downgraded: risk of bias, publication bias |
Aminoglycoside antibiotics ‐ nephrotoxicity | RR 0.67 [0.42, 1.06] | 4 studies · 493 participants | Low Downgraded: risk of bias, imprecision, publication bias |
Saving healthcare resources for saving healthcare resources
Population: saving healthcare resources
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Length of stay (days) | no estimate extracted | 9 studies · 18507 participants | Very low Downgraded: publication bias |
Length of stay (days) ‐ oral anticoagulants | no estimate extracted | 2 studies · 105 participants | Very low Downgraded: risk of bias, imprecision, publication bias |
Length of stay (days) ‐ insulin | no estimate extracted | 1 study · 128 participants | High |
Length of stay (days) ‐ theophylline | no estimate extracted | 3 studies · 151 participants | Low Downgraded: risk of bias, imprecision, publication bias |
Length of stay (days) ‐ aminoglycoside antibiotics | no estimate extracted | 2 studies · 295 participants | Moderate Downgraded: risk of bias, publication bias |
Length of stay (days) ‐ anti‐rejection drugs | no estimate extracted | 1 study · 17828 participants | Moderate Downgraded: publication bias |