Arch Intern Med 2000;160:301–8 This meta‐analysis of randomized trials of physician prompts to improve screening rates found that prompts do improve the rate of performing various health maintenance interventions. A prompt is defined as anything that tells a clinician to perform a screen. The most common prompts are stickers posted to charts of patients coming in for care and computer notices generated at the time of scheduled appointment. The effects on Pap smear screening rates were significantly less than the effect of prompting for other interventions. Prompting increased an average of only 5.8% as a result of prompts at a cost of $11.75 per additional Pap smear performed. The study lumped together various interventions that differed according to timing, information provided to clinicians, and location, but the way prompt was presented did not appear to affect results significantly. Comment: Prompting clinicians using computerized reminders or notes placed on the chart is effective, but the effect is not strong, suggesting that additional efforts may be needed to improve Pap smear screening rates in health systems. (LSM)
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