A Cochrane review [Abstract] 1 included 10 studies. Nine of them were RCTs, four cluster randomised controlled trials and five professional randomised controlled trials. All studies involved physicians as participants (including postgraduate trainees), and one study also included other participants. Only two studies measured patient outcomes. Searching skills and/or frequency of use of electronic databases, mainly MEDLINE, were targeted in eight studies. Use of Internet for audit and feedback, and email for provider-patient communication, were targeted in two studies.
Four studies showed small to moderate positive effects of the intervention on ICT adoption. Four studies were unable to demonstrate significant positive effects, and the two others showed mixed effects. No studies looked at the long-term effect or sustainability of the intervention.
Comment: The quality of evidence is downgraded by study quality (several issues), inconsistency (heterogeneity in interventions and outcomes) and imprecise results (limited study size for each comparison).
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