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J Am Med Inform Assoc 12:546-553 doi:10.1197/jamia.M1811
  • Original Investigation

Interventions to Regulate Ordering of Serum Magnesium Levels: Report of an Unintended Consequence of Decision Support

Table 3

Changes in Test Order Rates Associated With Decision Support Interventions

Orders* Instances*
Tests Value p Value† Value p Value†
Magnesium
 Mean weekly tests during baseline period 234 539
 Baseline trend in weekly tests 0.1 0.845 −0.5 0.163
 Weekly test rate after the first intervention‡ 219 0.640 378 0.001
 Weekly test rate after the second intervention 485 <0.001 491 0.022
 Trend change in the weekly test rate after the second intervention 0.6 0.315 1.5 0.050
 Weekly test rate after the third intervention 230 <0.001 277 <0.001
 Trend change in the weekly test rate related the third intervention 0.9 0.076 1.6 0.007
 Mean weekly test rate at the end of study period 320 379
Calcium
 Mean weekly tests during baseline period 200 400
 Baseline trend in weekly tests 0.1 0.924 −0.5 0.361
 Weekly test rate after the first intervention‡ 190 0.822 336 0.643
 Weekly test rate after the second intervention 368 0.113 452 0.541
 Trend change in the weekly test rate after the second intervention 2.5 0.012 3.6 0.003
 Weekly test rate after the third intervention 462 0.045 621 0.001
 Trend change in the weekly test rate related the third intervention 7.6 < 0.001 8.0 < 0.001
 Mean weekly test rate at the end of study period 1259 1417
Phosphorus
 Mean weekly tests during baseline period 108 282
 Baseline trend in weekly tests 0.1 0.662 0.1 0.777
 Weekly test rate after the first intervention‡ 107 0.823 227 0.056
 Weekly test rate after the second intervention 292 < 0.001 313 0.011
 Trend change in the weekly test rate after the second intervention 1.1 0.008 1.5 0.015
 Weekly test rate after the third intervention 229 0.008 289 0.189
 Trend change in the weekly test rate related the third intervention 0.7 0.054 0.8 0.057
 Mean weekly test rate at the end of study period 309 363
  • * All outcomes are corrected for changes in weekly admission rates.

  • p Values for “weekly test rate” tests the hypothesis that the current rate is the same as the preceding rate. p Values for “trend change” tests the hypothesis that the current trend is equal to zero.

  • Trends during the period when the first tool was implemented could not be tested due to inadequate sample.

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