Hi all RE: Effect of computerisation on quality of general practice care-a comparison with quality indicators. Henderson et al.
A few things to consider: 1. The data captured is from November 2003 to March 2005. Is over two years since a long time in using computers. Keep in mind I thought that computers were about efficiencies and safety first. 2. The lower prescribing rate is interesting for computer users given that it is now easier to prescribe than on paper. Is a possible explanation that GPs using computers are less likely recording prescriptions again on paper? - thereby creating a response bias. 3. The statistical power of the study - which would require greater detail of the occurrence of events. The 1200 odd GPs (Computers: 1069 vs Non computers: 188) only provided 100 consecutive encounters. Some of these quality indicators may not have the power to show an association if it is a small one. Depression occurs at 1.9 per 100 encs (from most recent report) thereby it is expected that there are 357 depression encounters in the Non-Computer GP group. You then put several factors into a multivariate analysis the statistical power is reduced again if there is in fact a real but small difference between the two groups. While the clinical significance argument comes into play when examining a small effect size, from a population significance argument a few percentage point changes can affect a lot given 100 million plus GP consultations a year. My humble opinion. Geoffrey Sayer HealthLink Ltd _______________________________________________ Gpcg_talk mailing list [email protected] http://ozdocit.org/cgi-bin/mailman/listinfo/gpcg_talk
