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Table 4 Comparison of the monthly number of diagnostic and lab tests prescribed per 100 consultations between control and intervention groups, before and after EHR software modification (independent sample t test with Bonferroni correction)

From: The effect of a test ordering software intervention on the prescription of unnecessary laboratory tests - a randomized controlled trial

 

Before (always exposed to usual EHR software)

After software modification (first month, washout period, excluded)

Control

Intervention

p

Cohen’s d

Control

Intervention

p

Cohen’s d

Diagnostic and lab tests that were withdrawn from the basic menu

 Uric acid

12.0

11.2

1.000

0.632

10.5

4.6

<0.001

6.138

 Serum protein electrophoresis

4.1

4.7

0.605

−1.039

3.2

0.6

<0.001

7.384

 Sedimentation rate

8.3

7.1

0.315

1.207

7.5

2.0

<0.001

10.818

 Rest electrocardiographya

7.7

6.4

0.465

1.073

6.6

5.4

0.070

1.544

 Lung X-ray

1.7

1.9

0.985

−0.802

1.5

1.4

1.000

0.441

All tests withdrawn

33.8

31.3

0.292

0.641

29.29

14.01

<0.001

7.174

Diagnostic and laboratory tests that were added to the basic menu

 HDL cholesterolb

19

16.7

0.640

0.958

17.2

15.9

1.000

0.702

 Triglycerides

19.6

17.4

0.830

0.862

17.7

16.1

0.640

0.874

 Faecal occult blood testb

8.5

4.9

0.015

2.207

6.9

6.2

0.425

1.003

Cervicovaginal cytologyb

4.8

4.5

1.000

0.468

4.5

4.4

1.000

0.361

Mammographyb

1.9

1.6

0.855

0.851

1.7

1.7

1.000

0.157

All tests added

53.7

45.0

0.070

1.172

48.0

44.3

0.158

0.805

Diagnostic and laboratory tests that were marked with green dots (USPSTF grade A and B)

 Glucose

22.7

20.4

0.864

0.914

20.9

18.6

0.228

1.246

 Total cholesterol

20.6

18.3

0.930

0.885

18.7

16.8

0.450

1.040

 Colonoscopy

1.4

1.2

0.042

1.943

1.5

1.1

0.006

2.345

 Flexible sigmoidoscopy

0.12

0.07

<0.001

3.002

0.05

0.08

0.186

−1.326

 DEXA

1.0

0.6

0.036

2.010

0.7

0.5

0.414

1.063

 VDRL

2.1

1.9

0.552

1.077

1.9

1.6

0.102

1.483

All green marked

82.1

70.2

0.070

1.170

74.1

66.8

0.070

1.064

Diagnostic and laboratory tests that were marked with red dots (USPSTF grade D)

 Pelvic ultrasound

1.20

1.04

0.084

1.774

1.02

1.08

1.000

−0.305

 Cancer antigen 19-9

0.18

0.13

0.616

1.093

0.17

0.08

<0.001

2.513

 Exercise electrocardiography

0.52

0.48

1.000

0.416

0.56

0.38

0.028

1.900

 Carotid artery ultrasound

0.27

0.23

1.000

0.750

0.25

0.15

0.021

1.978

 Spirometry

0.47

0.34

0.021

2.307

0.45

0.52

0.812

−0.902

 Hepatitis B surface antigen

1.60

1.34

0.084

1.756

1.59

1.24

0.028

1.925

 Hepatitis C antibodies

1.15

0.91

0.021

2.207

1.18

0.91

0.014

2.045

All red marked

13.1

10.9

0.021

1.583

11.8

9.8

0.003

1.941

  1. aTests that were also marked with red dots. bTests that were also marked with green dots
  2. α- DXA Dual-energy X-ray absorptiometry, β-VDRL Venereal Disease Research Laboratory
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BMC Medical Informatics and Decision Making

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