The number of studies and publications do not always correspond (e.g., a publication may include several studies or one study may be explained in several publications).
Effectiveness Review
Anaya H, Butler J, Solomon J, et al. Implementation of nurse-initiated rapid HIV testing at high prevalence primary care sites within the US Veterans Affairs health care system. Sexually Transmitted Diseases 2013;40(4):341-5.
Avery AK, Del Toro M, Einstadter D. Decreasing missed opportunities for HIV testing in primary care through enhanced utilization of the electronic medical record. Journal of AIDS and Clinical Research 2012;Suppl 4:10.4172/2155-6113.S4-006.
Burrell CN, Sharon MJ, Davis SM, Wojcik EM, Martin IB. Implementation of a collaborative HIV and hepatitis C screening program in Appalachian urgent care settings. Western Journal of Emergency Medicine 2018;19(6):1057.
Chadwick DR, Hall C, Rae C, Rayment MI, Branch M, et al. A feasibility study for a clinical decision support system prompting HIV testing. HIV Medicine 2017;18(6):435-9.
Clarke E, Bhatt S, Patel R, Samraj S. Audit of the effect of electronic patient records on uptake of HIV testing in a level 3 genitourinary medicine service. International Journal of STD and AIDS 2013;24(8):661-5.
Conners EE, Hagedorn HJ, Butler JN, Felmet K, Hoang T, et al. Evaluating the implementation of nurse-initiated HIV rapid testing in three Veterans Health Administration substance use disorder clinics. International Journal of STD and AIDS 2012;23(11):799-805.
Crumby NS, Arrezola E, Brown EH, Brazzeal A, and Sanchez TH. Experiences implementing a routine HIV screening program in two Federally Qualified Health Centers in the southern United States. Public Health Reports 2016;131(Supp 1):21-9.
Federman DG, Kravetz JD, Vasquez LS, Campbell SM. Improving human immunodeficiency virus testing rates with an electronic clinical reminder. American Journal of Medicine 2012;125(3):240-2.
Felsen UR, Cunningham CO, Heo M, et al. An expanded HIV testing strategy leveraging the electronic medical record uncovers undiagnosed infection among hospitalized patients. Journal of Acquired Immune Deficiency Syndrome 2017;75(1):27.
Goetz MB, Hoang T, Bowman C, et al. A system-wide intervention to improve HIV testing in the Veterans Health Administration. Journal of General Internal Medicine 2008;23(8):1200.
Goetz MB, Hoang T, Knapp H, et al. Central implementation strategies outperform local ones in improving HIV testing in Veterans Healthcare Administration facilities. Journal of General Internal Medicine 2013;28(10):1311-7.
Goetz MB, Hoang T, Knapp H, et al. Exportability of an intervention to increase HIV testing in the Veterans Health Administration. Joint Commission Journal on Quality and Patient Safety 2011;37(12):553-9.
Golden MR, Duchin J, Chew LD, et al. Impact of an electronic medical record-based system to promote human immunodeficiency virus/hepatitis C virus screening in public hospital primary care clinics. Paper presented at: Open Forum Infectious Diseases 2017.
Hechter RC, Bider-Canfield Z, Towner W. Effect of an electronic alert on targeted HIV testing among high-risk populations. Permanente Journal 2018;22:18-15.
Kershaw C, Taylor JL, Horowitz G, et al. Use of an electronic medical record reminder improves HIV screening. BMC Health Services Research 2018;18(1):14-21.
Lin J, Mauntel-Medici C, Heinert S, Baghikar S. Harnessing the power of the electronic medical record to facilitate an opt-out HIV screening program in an urban academic emergency department. Journal of Public Health Management and Practice 2017;23(3):264-8.
Marcelin JR, Tan EM, Marcelin A, et al. Assessment and improvement of HIV screening rates in a Midwest primary care practice using an electronic clinical decision support system: a quality improvement study. BMC Medical Informatics and Decision Making 2016;16(1):76.
Rodriguez V, Lester D, Connelly-Flores A, Barsanti FA, Hernandez P. Integrating routine HIV screening in the New York City community health center collaborative. Public Health Reports 2016;131(1_suppl):11-20.
Rudd S, Gemelas J, Reilley B, Leston J, Tulloch S. Integrating clinical decision support to increase HIV and chlamydia screening. Preventive Medicine 2013;57(6):908-9.
Schnall R, Liu N, Sperling J, et al. An electronic alert for HIV screening in the emergency department increases screening but not the diagnosis of HIV. Applied Clinical Informatics 2014;5(01):299-312.
Schnall R, Sperling JD, Liu N, et al. The effect of an electronic “hard-stop” alert on HIV testing rates in the emergency department. Studies in Health Technology and Informatics 2013;192:432-6.
Sha BE, Kniuksta R, Exner K, Kishen E, Shankaran S, et al. Evolution of an electronic health record based–human immunodeficiency virus (HIV) screening program in an urban emergency department for diagnosing acute and chronic HIV infection. Journal of Emergency Medicine 2019;57(5):732-9.
White DA, Todorovic T, Petti ML, Ellis KH, Anderson ES. A comparative effectiveness study of two nontargeted HIV and Hepatitis C virus screening algorithms in an urban emergency department. Annals of Emergency Medicine 2018;72(4):438-48.
Effectiveness Review
The systematic review science team completed a broad search for English-language papers that evaluated the impact of clinical decision support system interventions to increase HIV screening. Searches were conducted in the following databases: Medline, Embase, PsycINFO, Global Health, Scopus, Cochrane Library, and CINAHL. The search period was January 1, 1985 to October of 2019. Two team members independently screened each paper to determine eligibility. Uncertainties and disagreements were resolved by consensus among review team members.
Database |
Dates Searched |
Results |
Duplicates |
Unique Results |
Medline (OVID)
1945- |
10/22/19 |
8,763 |
31 |
8,732 |
Embase (OVID)
1947- |
10/22/19 |
2,805 |
1,683 |
1,122 |
PsycINFO (OVID)
1806- |
10/24/19 |
371 |
137 |
234 |
Global Health (OVID)
1910- |
10/24/19 |
544 |
321 |
223 |
Scopus
1960- |
10/25/19 |
6,996 |
1,363 |
5,633 |
Cochrane Library |
10/28/19 |
1,195 |
174 |
1,021 |
CINAHL (Ebsco) |
10/28/19 |
908 |
491 |
417 |
Total |
|
21,582 |
4,200 |
17,382 |
Notes: Duplicates were identified using EndNote automated “find duplicates” function with preference set to match on title, author, and year. There will likely be additional duplicates found that EndNote was unable to detect.
Database: Medline (OVID)
1 exp Decision Support Systems, Clinical/
2 Therapy, Computer-Assisted/
3 Reminder Systems/
4 Decision Making, Computer-Assisted/
5 (clinical decision support system* or computer assisted therapy or reminder system* or computer assisted decision making).ti,ab.
6 ((computer* or electronic) and (alert* or reminder*)).ti,ab.
7 decision support system*.ti,ab.
8 Mass Screening/
9 mass screening*.ti,ab.
10 medical records systems, computerized/ or exp electronic health records/
11 ((electronic or online or on-line) and (record* adj1 (medical or patient or health))).ti,ab.
12 exp HIV/ or exp Acquired Immunodeficiency Syndrome/
13 (sexually transmitted diseases or sexually transmitted infections or acquired immune deficiency syndrome or human immunodeficiency virus).ti,ab.
14 (AIDS or STD or STDs or STI or "STIs" or HIV or HIV testing or HIV test or HIV screen*).ti,ab.
15 12 or 13 or 14
16 or/1-11
17 15 and 16
18 exp Animals/ or exp Nonhuman/
19 Humans/
20 18 not 19
21 17 not 20
22 17 not (animals not humans).sh.
23 limit 22 to (english language and yr="1985 -Current")
Database: Embase (OVID)
1 exp Decision Support Systems, Clinical/
2 Therapy, Computer-Assisted/
3 Reminder Systems/
4 Decision Making, Computer-Assisted/
5 (clinical decision support system* or computer assisted therapy or reminder system* or computer assisted decision making).ti,ab.
6 ((computer* or electronic) and (alert* or reminder*)).ti,ab.
7 decision support system*.ti,ab.
8 Mass Screening/
9 mass screening*.ti,ab.
10 medical records systems, computerized/ or exp electronic health records/
11 ((electronic or online or on-line) and (record* adj1 (medical or patient or health))).ti,ab.
12 exp HIV/ or exp Acquired Immunodeficiency Syndrome/
13 (sexually transmitted diseases or sexually transmitted infections or acquired immune deficiency syndrome or human immunodeficiency virus).ti,ab.
14 (AIDS or STD or STDs or STI or "STIs" or HIV or HIV testing or HIV test or HIV screen*).ti,ab.
15 12 or 13 or 14
16 or/1-11
17 15 and 16
18 exp Animals/ or exp Nonhuman/
19 Humans/
20 18 not 19
21 17 not 20
22 limit 21 to (english language and yr="1985 -Current")
Database: PsycINFO (OVID)
1 computer assisted therapy/
2 exp Decision Support Systems/
3 (clinical decision support system* or computer assisted therapy or reminder system* or computer assisted decision making).ti,ab.
4 ((computer* or electronic) and (alert* or reminder*)).ti,ab.
5 decision support system*.ti,ab.
6 mass screening*.ti,ab.
7 medical records systems, computerized/ or exp electronic health records/
8 ((electronic or online or on-line) and (record* adj1 (medical or patient or health))).ti,ab.
9 exp HIV/ or exp Acquired Immunodeficiency Syndrome/
10 (sexually transmitted diseases or sexually transmitted infections or acquired immune deficiency syndrome or human immunodeficiency virus).ti,ab.
11 (AIDS or STD or STDs or STI or "STIs" or HIV or HIV testing or HIV test or HIV screen*).ti,ab.
12 1 or 2 or 3 or 4 or 5 or 6 or 7 or 8
13 9 or 10 or 11
14 12 and 13
15 limit 14 to (english language and yr="1985 -Current")
Database: Global Health (OVID)
1 exp decision support systems/
2 (clinical decision support system* or computer assisted therapy or reminder system* or computer assisted decision making).ti,ab.
3 ((computer* or electronic) and (alert* or reminder*)).ti,ab.
4 decision support system*.ti,ab.
5 mass screening*.ti,ab.
6 ((electronic or online or on-line) and (record* adj1 (medical or patient or health))).ti,ab.
7 or/1-6
8 exp HIV/
9 exp acquired immune deficiency syndrome/
10 (sexually transmitted diseases or sexually transmitted infections or acquired immune deficiency syndrome or human immunodeficiency virus).ti,ab.
11 (AIDS or STD or STDs or STI or "STIs" or HIV or HIV testing or HIV test or HIV screen*).ti,ab.
12 8 or 9 or 10 or 11
13 7 and 12
14 limit 13 to (english language and yr="1985 -Current")
Database: Scopus
(( INDEXTERMS( "Decision Support Systems" OR "Reminder Systems" OR "electronic health records") OR TITLE-ABS("decision support system" OR "decision support systems" OR "computer assisted therapy" OR "computer assisted therapies" OR "reminder system" OR "computer assisted decision making" OR "mass screening" ) OR TITLE-ABS(( computer* OR electronic" ) AND (alert* OR reminder*" )) OR TITLE-ABS( record* W/1 (medical OR patient* OR "health" )) ) AND ( INDEXTERMS( "HIV" OR "Acquired Immunodeficiency Syndrome" ) OR TITLE-ABS( "sexually transmitted diseases" OR "sexually transmitted infections" OR "acquired immune deficiency syndrome" OR "human immunodeficiency virus" OR AIDS OR STD OR STDs OR STI OR STIs OR HIV))) AND LIMIT-TO ( PUBYEAR) 1985 – 2019
AND ( LIMIT-TO ( LANGUAGE , "English" ) )
Database: Cochrane
#1 ("clinical decision support system*" or "computer assisted therapy" or "reminder system*" or "computer assisted decision making"):ab,ti
#2 ((computer* or electronic) and (alert* or reminder*)):ab,ti
#3 decision support system*:ti,ab
#4 mass screening:ti,ab
#5 ((electronic OR online OR on-line) AND (record* NEAR/1 (medical OR patient OR health))):ti,ab
#6 ("sexually transmitted diseases" OR "sexually transmitted infections" OR "acquired immune deficiency syndrome" OR "human immunodeficiency virus"):ti,ab
#7 (AIDS or STD or STDs or STI or "STIs" or HIV or HIV testing or HIV test or HIV screen*):ti,ab
#8 #1 OR #2 OR #3 OR #4
#9 #5 OR #6 OR #7
#10 #8 AND #9 with Cochrane Library publication date Between Jan 1985 and Oct 2019
#11 #10 with Publication Year from 1985 to 2019, in Trials
Database: CINAHL
S18 S12 AND S17
S17 S13 OR S14 OR S15 OR S16
S16 TI ( AIDS or STD or STDs or STIs or HIV or HIV testing or HIV test or HIV screen* ) OR AB ( AIDS or STD or STDs or STIs or HIV or HIV testing or HIV test or HIV screen* )
S15 TI ( sexually transmitted disease* or sexually transmitted infection* or acquired immune deficiency syndrome or human immunodeficiency virus ) OR AB ( sexually transmitted disease* or sexually transmitted infection* or acquired immune deficiency syndrome or human immunodeficiency virus )
S14 (MH "HIV Infections+")
S13 (MH "Human Immunodeficiency Virus+")
S12 S1 OR S2 OR S3 OR S4 OR S5 OR S6 OR S7 OR S9 OR S10 OR S11
S11 TI ( ((electronic or online or on-line) and (record* N1 (medical or patient or health))) ) OR AB ( ((electronic or online or on-line) and (record* N1 (medical or patient or health)))
S10 TI computerized medical records system* OR AB computerized medical records system*
S9 (MH "Electronic Health Records+")
S8 computerized medical record systems
S7 TI mass screening* OR AB mass screening*
S6 TI decision support system* OR AB decision support system*
S5 TI ( ((computer* or electronic) N3 (alert* or reminder*)) ) OR AB ( ((computer* or electronic) N3 (alert* or reminder*)) )
S4 TI ( (clinical decision support system* or computer assisted therapy or reminder system* or computer assisted decision making) ) OR AB ( (clinical decision support system* or computer assisted therapy or reminder system* or computer assisted decision making) )
S3 (MH "Reminder Systems")
S2 (MH "Therapy, Computer-Assisted")
S1 MH "Decision Support Systems, Clinical+")