Association between e-alert implementation for detection of acute kidney injury and outcomes: a systematic review
Background. Electronic alerts (e-alerts) for acute kidney injury (AKI) in hospitalized patients are increasingly being implemented; however, their impact on outcomes remains uncertain. Methods. We performed a systematic review. Electronic databases and grey literature were searched for original s...
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| Format: | Article |
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Oxford University Press
2017
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| Online Access: | https://eprints.nottingham.ac.uk/42628/ |
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| author | Lachance, Philippe Villeneuve, Pierre-Marc Rewa, Oleksa G. Wilson, Francis P. Selby, Nicholas M. Featherstone, Robin M. Bagshaw, Sean M. |
| author_facet | Lachance, Philippe Villeneuve, Pierre-Marc Rewa, Oleksa G. Wilson, Francis P. Selby, Nicholas M. Featherstone, Robin M. Bagshaw, Sean M. |
| author_sort | Lachance, Philippe |
| building | Nottingham Research Data Repository |
| collection | Online Access |
| description | Background. Electronic alerts (e-alerts) for acute kidney injury (AKI) in hospitalized patients are increasingly being implemented; however, their impact on outcomes remains uncertain.
Methods. We performed a systematic review. Electronic databases and grey literature were searched for original studies published between 1990 and 2016. Randomized, quasi-randomized, observational and before-and-after studies that included hospitalized patients, implemented e-alerts for AKI and described their impact on one of care processes, patient-centred outcomes or resource utilization measures were included.
Results. Our search yielded six studies (n = 10 165 patients). E-alerts were generally automated, triggered through electronic health records and not linked to clinical decision support. In pooled analysis, e-alerts did not improve mortality [odds ratio (OR) 1.05; 95% confidence intervals (CI), 0.84–1.31; n = 3 studies; n = 3425 patients; I2 = 0%] or reduce renal replacement therapy (RRT) use (OR 1.20; 95% CI, 0.91–1.57; n = 2 studies; n = 3236 patients; I2 = 0%). Isolated studies reported improvements in selected care processes. Pooled analysis found no significant differences in prescribed fluid therapy.
Conclusions. In the available studies, e-alerts for AKI do not improve survival or reduce RRT utilization. The impact of e-alerts on processes of care was variable. Additional research is needed to understand those aspects of e-alerts that are most likely to improve care processes and outcomes. |
| first_indexed | 2025-11-14T19:49:27Z |
| format | Article |
| id | nottingham-42628 |
| institution | University of Nottingham Malaysia Campus |
| institution_category | Local University |
| last_indexed | 2025-11-14T19:49:27Z |
| publishDate | 2017 |
| publisher | Oxford University Press |
| recordtype | eprints |
| repository_type | Digital Repository |
| spelling | nottingham-426282020-05-04T18:30:41Z https://eprints.nottingham.ac.uk/42628/ Association between e-alert implementation for detection of acute kidney injury and outcomes: a systematic review Lachance, Philippe Villeneuve, Pierre-Marc Rewa, Oleksa G. Wilson, Francis P. Selby, Nicholas M. Featherstone, Robin M. Bagshaw, Sean M. Background. Electronic alerts (e-alerts) for acute kidney injury (AKI) in hospitalized patients are increasingly being implemented; however, their impact on outcomes remains uncertain. Methods. We performed a systematic review. Electronic databases and grey literature were searched for original studies published between 1990 and 2016. Randomized, quasi-randomized, observational and before-and-after studies that included hospitalized patients, implemented e-alerts for AKI and described their impact on one of care processes, patient-centred outcomes or resource utilization measures were included. Results. Our search yielded six studies (n = 10 165 patients). E-alerts were generally automated, triggered through electronic health records and not linked to clinical decision support. In pooled analysis, e-alerts did not improve mortality [odds ratio (OR) 1.05; 95% confidence intervals (CI), 0.84–1.31; n = 3 studies; n = 3425 patients; I2 = 0%] or reduce renal replacement therapy (RRT) use (OR 1.20; 95% CI, 0.91–1.57; n = 2 studies; n = 3236 patients; I2 = 0%). Isolated studies reported improvements in selected care processes. Pooled analysis found no significant differences in prescribed fluid therapy. Conclusions. In the available studies, e-alerts for AKI do not improve survival or reduce RRT utilization. The impact of e-alerts on processes of care was variable. Additional research is needed to understand those aspects of e-alerts that are most likely to improve care processes and outcomes. Oxford University Press 2017-01-14 Article PeerReviewed Lachance, Philippe, Villeneuve, Pierre-Marc, Rewa, Oleksa G., Wilson, Francis P., Selby, Nicholas M., Featherstone, Robin M. and Bagshaw, Sean M. (2017) Association between e-alert implementation for detection of acute kidney injury and outcomes: a systematic review. Nephrology Dialysis Transplantation, 32 (2). pp. 265-272. ISSN 1460-2385 acute kidney injury clinical decision support electronic alert meta-analysis systematic review https://academic.oup.com/ndt/article-lookup/doi/10.1093/ndt/gfw424 doi:10.1093/ndt/gfw424 doi:10.1093/ndt/gfw424 |
| spellingShingle | acute kidney injury clinical decision support electronic alert meta-analysis systematic review Lachance, Philippe Villeneuve, Pierre-Marc Rewa, Oleksa G. Wilson, Francis P. Selby, Nicholas M. Featherstone, Robin M. Bagshaw, Sean M. Association between e-alert implementation for detection of acute kidney injury and outcomes: a systematic review |
| title | Association between e-alert implementation for detection of acute kidney injury and outcomes: a systematic review |
| title_full | Association between e-alert implementation for detection of acute kidney injury and outcomes: a systematic review |
| title_fullStr | Association between e-alert implementation for detection of acute kidney injury and outcomes: a systematic review |
| title_full_unstemmed | Association between e-alert implementation for detection of acute kidney injury and outcomes: a systematic review |
| title_short | Association between e-alert implementation for detection of acute kidney injury and outcomes: a systematic review |
| title_sort | association between e-alert implementation for detection of acute kidney injury and outcomes: a systematic review |
| topic | acute kidney injury clinical decision support electronic alert meta-analysis systematic review |
| url | https://eprints.nottingham.ac.uk/42628/ https://eprints.nottingham.ac.uk/42628/ https://eprints.nottingham.ac.uk/42628/ |