Re: Attitudes of hospital workers towards electronic medical records

[Franklin Valier]

"The second preexperemintal design discussed by Campbell and Stanley adds a 
pretest for the experimental group but lacks a control group.  This 
design--which the authors call the one-group pretest posttest 
design--suffers from the possibility that some factor other than the 
independent variable might cause a change between the pretest and posttest 
results, such as the assassination of a respected African-American leader. 
Thus, although we can see that prejudice has been reduced, we cant be sure 
the film caused the reduction."

Babbie, E., "The Practice of Social Research," Wadsworth Publishing Company, 
8th ed., 1998, p 240.

----- Original Message ----- 
From: "Tim Churches" <[EMAIL PROTECTED]>
To: <openhealth-list@minoru-development.com>
Sent: Friday, May 20, 2005 7:22 PM
Subject: Re: Attitudes of hospital workers towards electronic medical 
records


Franklin Valier wrote:
In science this type of study only has value as to its scientifically
agreed upon use.  Its ability to be relied upon to make reliable
conclusions from the methodology has to be taken into perspective when
reading the study.  It has value, but in science you don't take it too
seriously.  We rely on empirical studies for serious evaluation of a
phenomena.  If they haven't been done, all you can say is this is all
have and this is all we know right now.  Not much.  I wouldn't get too
upset about this.
I think that you are being overly dismissive of observational studies.
Controlled experiments are great, but a) they can be hard to arrange
when the thing being tested is a hospital-wide information system which
costs tens of millions of dollars to implement and b) controlled trials
can introduce their own sets of biases and limit generalisability due to
overly tight selection criteria. And how practical is it to randomise
whole hospitals to "get teh computer system" or "stay with paper"?
OPolitically that is rather hard to do.
Certainly in the case of evaluations of implementations of hospital and
other clinical infromations systems it is best to use a before-and-after
study design, in which the hospital acts as its own matched control, and
the same survey instruments and methods are used before and after the
implementation of the system. It is easy to say that in retrospect, but
getting money from management to commission an expensive evaluation
study of a new information system BEFORE the system has even begun to be
installed can be a challenge, I suspect.
Tim C