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- Title
A randomized controlled trial of screening for maternal depression with a clinical decision support system.
- Authors
Carroll, Aaron E.; Biondich, Paul; Anand, Vibha; Dugan, Tamara M.; Downs, Stephen M.
- Abstract
Objective To determine if automated screening and just in time delivery of testing and referral materials at the point of care promotes universal screening referral rates for maternal depression. Methods The Child Health Improvement through Computer Automation (CHICA) system is a decision support and electronic medical record system used in our pediatric clinics. All families of patients up to 15 months of age seen between October 2007 and July 2009 were randomized to one of three groups: (1) screening questions printed on prescreener forms (PSF) completed by mothers in the waiting room with physician alerts for positive screens, (2) everything in (1) plus 'just in time' (JIT) printed materials to aid physicians, and (3) a control group where physicians were simply reminded to screen on printed physician worksheets. Results The main outcome of interest was whether physicians suspected a diagnosis of maternal depression and referred a mother for assistance. This occurred significantly more often in both the PSF (2.4%) and JIT groups (2.4%) than in the control group (1.2%) (OR 2.06, 95% CI 1.08 to 3.93). Compared to the control group, more mothers were noted to have depressed mood in the PSF (OR 7.93, 95% CI 4.51 to 13.96) and JIT groups (OR 8.10, 95% CI 4.61 to 14.25). Similarly, compared to the control group, more mothers had signs of anhedonia in the PSF (OR 12.58, 95% CI 5.03 to 31.46) and JIT groups (OR 13.03, 95% CI 5.21 to 32.54). Conclusions Clinical decision support systems like CHICA can improve the screening of maternal depression.
- Subjects
DEPRESSION in women; DECISION support systems -- Medical applications; RANDOMIZED controlled trials; JUST-in-time systems; POINT-of-care testing; PSYCHOLOGY of mothers; DEPRESSION in parents; DIAGNOSIS
- Publication
Journal of the American Medical Informatics Association, 2013, Vol 20, Issue 2, p311
- ISSN
1067-5027
- Publication type
Article
- DOI
10.1136/amiajnl-2011-000682