{"id":"https://openalex.org/W2148794355","doi":"https://doi.org/10.1136/amiajnl-2011-000743","title":"Evaluating alert fatigue over time to EHR-based clinical trial alerts: findings from a randomized controlled study","display_name":"Evaluating alert fatigue over time to EHR-based clinical trial alerts: findings from a randomized controlled study","publication_year":2012,"publication_date":"2012-04-26","ids":{"openalex":"https://openalex.org/W2148794355","doi":"https://doi.org/10.1136/amiajnl-2011-000743","mag":"2148794355","pmid":"https://pubmed.ncbi.nlm.nih.gov/22534081"},"language":"en","primary_location":{"id":"doi:10.1136/amiajnl-2011-000743","is_oa":true,"landing_page_url":"https://doi.org/10.1136/amiajnl-2011-000743","pdf_url":"https://academic.oup.com/jamia/article-pdf/19/e1/e145/9517102/19-e1-e145.pdf","source":{"id":"https://openalex.org/S129839026","display_name":"Journal of the American Medical Informatics Association","issn_l":"1067-5027","issn":["1067-5027","1527-974X"],"is_oa":false,"is_in_doaj":false,"is_core":true,"host_organization":"https://openalex.org/P4310311648","host_organization_name":"Oxford University Press","host_organization_lineage":["https://openalex.org/P4310311648","https://openalex.org/P4310311647"],"host_organization_lineage_names":["Oxford University Press","University of Oxford"],"type":"journal"},"license":"cc-by-nc","license_id":"https://openalex.org/licenses/cc-by-nc","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Journal of the American Medical Informatics Association","raw_type":"journal-article"},"type":"article","indexed_in":["crossref","pubmed"],"open_access":{"is_oa":true,"oa_status":"hybrid","oa_url":"https://academic.oup.com/jamia/article-pdf/19/e1/e145/9517102/19-e1-e145.pdf","any_repository_has_fulltext":true},"authorships":[{"author_position":"first","author":{"id":"https://openalex.org/A5015307002","display_name":"Peter J. Emb\u00ed","orcid":"https://orcid.org/0000-0002-7733-0847"},"institutions":[{"id":"https://openalex.org/I52357470","display_name":"The Ohio State University","ror":"https://ror.org/00rs6vg23","country_code":"US","type":"education","lineage":["https://openalex.org/I52357470"]}],"countries":["US"],"is_corresponding":true,"raw_author_name":"P. J. Embi","raw_affiliation_strings":["Department of Biomedical Informatics, College of Medicine, The Ohio State University, Columbus, Ohio 43210, USA. peter.embi@osumc.edu","Departments of Biomedical Informatics and Internal Medicine, College of Medicine, The Ohio State University, Columbus, Ohio, USA"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Department of Biomedical Informatics, College of Medicine, The Ohio State University, Columbus, Ohio 43210, USA. peter.embi@osumc.edu","institution_ids":["https://openalex.org/I52357470"]},{"raw_affiliation_string":"Departments of Biomedical Informatics and Internal Medicine, College of Medicine, The Ohio State University, Columbus, Ohio, USA","institution_ids":["https://openalex.org/I52357470"]}]},{"author_position":"last","author":{"id":"https://openalex.org/A5086132499","display_name":"Anthony C. Leonard","orcid":"https://orcid.org/0000-0003-2193-8084"},"institutions":[{"id":"https://openalex.org/I92156820","display_name":"University of Cincinnati Medical Center","ror":"https://ror.org/02p72h367","country_code":"US","type":"healthcare","lineage":["https://openalex.org/I92156820"]}],"countries":["US"],"is_corresponding":false,"raw_author_name":"A. C. Leonard","raw_affiliation_strings":["Department of Family and Community Medicine, College of Medicine, University of Cincinnati, Cincinnati, Ohio, USA"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Department of Family and Community Medicine, College of Medicine, University of Cincinnati, Cincinnati, Ohio, USA","institution_ids":["https://openalex.org/I92156820"]}]}],"institutions":[],"countries_distinct_count":1,"institutions_distinct_count":2,"corresponding_author_ids":["https://openalex.org/A5015307002"],"corresponding_institution_ids":["https://openalex.org/I52357470"],"apc_list":{"value":3967,"currency":"USD","value_usd":3967},"apc_paid":{"value":3967,"currency":"USD","value_usd":3967},"fwci":27.2177,"has_fulltext":true,"cited_by_count":199,"citation_normalized_percentile":{"value":0.99606222,"is_in_top_1_percent":true,"is_in_top_10_percent":true},"cited_by_percentile_year":{"min":94,"max":100},"biblio":{"volume":"19","issue":"e1","first_page":"e145","last_page":"e148"},"is_retracted":false,"is_paratext":false,"is_xpac":false,"primary_topic":{"id":"https://openalex.org/T10350","display_name":"Electronic Health Records Systems","score":0.9240000247955322,"subfield":{"id":"https://openalex.org/subfields/3605","display_name":"Health Information Management"},"field":{"id":"https://openalex.org/fields/36","display_name":"Health Professions"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},"topics":[{"id":"https://openalex.org/T10350","display_name":"Electronic Health Records Systems","score":0.9240000247955322,"subfield":{"id":"https://openalex.org/subfields/3605","display_name":"Health Information Management"},"field":{"id":"https://openalex.org/fields/36","display_name":"Health Professions"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T10582","display_name":"Ethics in Clinical Research","score":0.02199999988079071,"subfield":{"id":"https://openalex.org/subfields/2739","display_name":"Public Health, Environmental and Occupational Health"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T11446","display_name":"Mobile Health and mHealth Applications","score":0.006899999920278788,"subfield":{"id":"https://openalex.org/subfields/3600","display_name":"General Health Professions"},"field":{"id":"https://openalex.org/fields/36","display_name":"Health Professions"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}}],"keywords":[{"id":"https://openalex.org/keywords/electronic-health-record","display_name":"Electronic health record","score":0.6838175654411316},{"id":"https://openalex.org/keywords/medicine","display_name":"Medicine","score":0.6063427329063416},{"id":"https://openalex.org/keywords/clinical-trial","display_name":"Clinical trial","score":0.5575796961784363},{"id":"https://openalex.org/keywords/randomized-controlled-trial","display_name":"Randomized controlled trial","score":0.5027155876159668},{"id":"https://openalex.org/keywords/health-records","display_name":"Health records","score":0.4587121605873108},{"id":"https://openalex.org/keywords/patient-recruitment","display_name":"Patient recruitment","score":0.4533313512802124},{"id":"https://openalex.org/keywords/medical-emergency","display_name":"Medical emergency","score":0.3920915424823761},{"id":"https://openalex.org/keywords/health-care","display_name":"Health care","score":0.39076346158981323}],"concepts":[{"id":"https://openalex.org/C3020144179","wikidata":"https://www.wikidata.org/wiki/Q10871684","display_name":"Electronic health record","level":3,"score":0.6838175654411316},{"id":"https://openalex.org/C71924100","wikidata":"https://www.wikidata.org/wiki/Q11190","display_name":"Medicine","level":0,"score":0.6063427329063416},{"id":"https://openalex.org/C535046627","wikidata":"https://www.wikidata.org/wiki/Q30612","display_name":"Clinical trial","level":2,"score":0.5575796961784363},{"id":"https://openalex.org/C168563851","wikidata":"https://www.wikidata.org/wiki/Q1436668","display_name":"Randomized controlled trial","level":2,"score":0.5027155876159668},{"id":"https://openalex.org/C3019952477","wikidata":"https://www.wikidata.org/wiki/Q1324077","display_name":"Health records","level":3,"score":0.4587121605873108},{"id":"https://openalex.org/C2779174308","wikidata":"https://www.wikidata.org/wiki/Q17092352","display_name":"Patient recruitment","level":3,"score":0.4533313512802124},{"id":"https://openalex.org/C545542383","wikidata":"https://www.wikidata.org/wiki/Q2751242","display_name":"Medical emergency","level":1,"score":0.3920915424823761},{"id":"https://openalex.org/C160735492","wikidata":"https://www.wikidata.org/wiki/Q31207","display_name":"Health care","level":2,"score":0.39076346158981323},{"id":"https://openalex.org/C50522688","wikidata":"https://www.wikidata.org/wiki/Q189833","display_name":"Economic growth","level":1,"score":0.0},{"id":"https://openalex.org/C142724271","wikidata":"https://www.wikidata.org/wiki/Q7208","display_name":"Pathology","level":1,"score":0.0},{"id":"https://openalex.org/C162324750","wikidata":"https://www.wikidata.org/wiki/Q8134","display_name":"Economics","level":0,"score":0.0},{"id":"https://openalex.org/C141071460","wikidata":"https://www.wikidata.org/wiki/Q40821","display_name":"Surgery","level":1,"score":0.0}],"mesh":[{"descriptor_ui":"D005221","descriptor_name":"Fatigue","qualifier_ui":null,"qualifier_name":null,"is_major_topic":true},{"descriptor_ui":"D005221","descriptor_name":"Fatigue","qualifier_ui":null,"qualifier_name":null,"is_major_topic":true},{"descriptor_ui":"D005221","descriptor_name":"Fatigue","qualifier_ui":null,"qualifier_name":null,"is_major_topic":true},{"descriptor_ui":"D006801","descriptor_name":"Humans","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D006801","descriptor_name":"Humans","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D006801","descriptor_name":"Humans","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D010820","descriptor_name":"Physicians","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D010820","descriptor_name":"Physicians","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D010820","descriptor_name":"Physicians","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D014584","descriptor_name":"User-Computer Interface","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D014584","descriptor_name":"User-Computer Interface","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D014584","descriptor_name":"User-Computer Interface","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D016032","descriptor_name":"Randomized Controlled Trials as Topic","qualifier_ui":null,"qualifier_name":null,"is_major_topic":true},{"descriptor_ui":"D016032","descriptor_name":"Randomized Controlled Trials as Topic","qualifier_ui":null,"qualifier_name":null,"is_major_topic":true},{"descriptor_ui":"D016032","descriptor_name":"Randomized Controlled Trials as Topic","qualifier_ui":null,"qualifier_name":null,"is_major_topic":true},{"descriptor_ui":"D018579","descriptor_name":"Patient Selection","qualifier_ui":null,"qualifier_name":null,"is_major_topic":true},{"descriptor_ui":"D018579","descriptor_name":"Patient Selection","qualifier_ui":null,"qualifier_name":null,"is_major_topic":true},{"descriptor_ui":"D018579","descriptor_name":"Patient Selection","qualifier_ui":null,"qualifier_name":null,"is_major_topic":true},{"descriptor_ui":"D057286","descriptor_name":"Electronic Health Records","qualifier_ui":null,"qualifier_name":null,"is_major_topic":true},{"descriptor_ui":"D057286","descriptor_name":"Electronic Health Records","qualifier_ui":null,"qualifier_name":null,"is_major_topic":true},{"descriptor_ui":"D057286","descriptor_name":"Electronic Health Records","qualifier_ui":null,"qualifier_name":null,"is_major_topic":true}],"locations_count":3,"locations":[{"id":"doi:10.1136/amiajnl-2011-000743","is_oa":true,"landing_page_url":"https://doi.org/10.1136/amiajnl-2011-000743","pdf_url":"https://academic.oup.com/jamia/article-pdf/19/e1/e145/9517102/19-e1-e145.pdf","source":{"id":"https://openalex.org/S129839026","display_name":"Journal of the American Medical Informatics Association","issn_l":"1067-5027","issn":["1067-5027","1527-974X"],"is_oa":false,"is_in_doaj":false,"is_core":true,"host_organization":"https://openalex.org/P4310311648","host_organization_name":"Oxford University Press","host_organization_lineage":["https://openalex.org/P4310311648","https://openalex.org/P4310311647"],"host_organization_lineage_names":["Oxford University Press","University of Oxford"],"type":"journal"},"license":"cc-by-nc","license_id":"https://openalex.org/licenses/cc-by-nc","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Journal of the American Medical Informatics Association","raw_type":"journal-article"},{"id":"pmid:22534081","is_oa":false,"landing_page_url":"https://pubmed.ncbi.nlm.nih.gov/22534081","pdf_url":null,"source":{"id":"https://openalex.org/S4306525036","display_name":"PubMed","issn_l":null,"issn":null,"is_oa":false,"is_in_doaj":false,"is_core":false,"host_organization":"https://openalex.org/I1299303238","host_organization_name":"National Institutes of Health","host_organization_lineage":["https://openalex.org/I1299303238"],"host_organization_lineage_names":[],"type":"repository"},"license":null,"license_id":null,"version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Journal of the American Medical Informatics Association : JAMIA","raw_type":null},{"id":"pmh:oai:europepmc.org:2398848","is_oa":true,"landing_page_url":"https://www.ncbi.nlm.nih.gov/pmc/articles/3392862","pdf_url":null,"source":{"id":"https://openalex.org/S4306400806","display_name":"Europe PMC (PubMed Central)","issn_l":null,"issn":null,"is_oa":false,"is_in_doaj":false,"is_core":false,"host_organization":"https://openalex.org/I1303153112","host_organization_name":"European Bioinformatics Institute","host_organization_lineage":["https://openalex.org/I1303153112"],"host_organization_lineage_names":[],"type":"repository"},"license":"other-oa","license_id":"https://openalex.org/licenses/other-oa","version":"submittedVersion","is_accepted":false,"is_published":false,"raw_source_name":null,"raw_type":"Text"}],"best_oa_location":{"id":"doi:10.1136/amiajnl-2011-000743","is_oa":true,"landing_page_url":"https://doi.org/10.1136/amiajnl-2011-000743","pdf_url":"https://academic.oup.com/jamia/article-pdf/19/e1/e145/9517102/19-e1-e145.pdf","source":{"id":"https://openalex.org/S129839026","display_name":"Journal of the American Medical Informatics Association","issn_l":"1067-5027","issn":["1067-5027","1527-974X"],"is_oa":false,"is_in_doaj":false,"is_core":true,"host_organization":"https://openalex.org/P4310311648","host_organization_name":"Oxford University Press","host_organization_lineage":["https://openalex.org/P4310311648","https://openalex.org/P4310311647"],"host_organization_lineage_names":["Oxford University Press","University of Oxford"],"type":"journal"},"license":"cc-by-nc","license_id":"https://openalex.org/licenses/cc-by-nc","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Journal of the American Medical Informatics Association","raw_type":"journal-article"},"sustainable_development_goals":[],"awards":[],"funders":[{"id":"https://openalex.org/F4320332161","display_name":"National Institutes of Health","ror":"https://ror.org/01cwqze88"},{"id":"https://openalex.org/F4320337372","display_name":"U.S. National Library of Medicine","ror":"https://ror.org/0060t0j89"}],"has_content":{"pdf":true,"grobid_xml":true},"content_urls":{"pdf":"https://content.openalex.org/works/W2148794355.pdf","grobid_xml":"https://content.openalex.org/works/W2148794355.grobid-xml"},"referenced_works_count":19,"referenced_works":["https://openalex.org/W21284159","https://openalex.org/W43248758","https://openalex.org/W217923085","https://openalex.org/W1516037026","https://openalex.org/W1829418587","https://openalex.org/W1969488859","https://openalex.org/W1985617145","https://openalex.org/W1999675692","https://openalex.org/W2004339122","https://openalex.org/W2025472120","https://openalex.org/W2044859414","https://openalex.org/W2057416589","https://openalex.org/W2096173154","https://openalex.org/W2101692118","https://openalex.org/W2110922423","https://openalex.org/W2131675703","https://openalex.org/W2207249009","https://openalex.org/W4213270426","https://openalex.org/W4235933432"],"related_works":["https://openalex.org/W187932805","https://openalex.org/W1641026212","https://openalex.org/W4312053962","https://openalex.org/W2078646730","https://openalex.org/W2087134418","https://openalex.org/W2323588885","https://openalex.org/W3047677938","https://openalex.org/W2920854314","https://openalex.org/W4302340031","https://openalex.org/W2398973086"],"abstract_inverted_index":{"OBJECTIVE:":[0],"Inadequate":[1],"participant":[2,27],"recruitment":[3,28],"is":[4],"a":[5,78,143,150],"major":[6],"problem":[7],"facing":[8],"clinical":[9,21,31,99],"research.":[10],"Recent":[11],"studies":[12],"have":[13],"demonstrated":[14,149],"that":[15,136,139],"electronic":[16],"health":[17],"record":[18],"(EHR)-based,":[19],"point-of-care,":[20],"trial":[22],"alerts":[23,57,133],"(CTA)":[24],"can":[25],"improve":[26],"to":[29,39,50,55,59,64,70,93,108,227],"certain":[30],"research":[32],"studies.":[33],"Despite":[34],"their":[35],"promise,":[36],"much":[37],"remains":[38],"be":[40],"learned":[41],"about":[42],"the":[43,85,109,126,129,181,228],"use":[44],"of":[45,88,121,128,132,211,234,248],"CTAs.":[46,249],"Our":[47],"objective":[48],"was":[49],"study":[51,80,247],"whether":[52],"repeated":[53],"exposure":[54],"such":[56],"leads":[58],"declining":[60],"user":[61],"responsiveness":[62,196],"and":[63,111,238,245],"characterize":[65],"its":[66],"extent":[67],"if":[68],"present":[69],"better":[71],"inform":[72,241],"future":[73,242],"CTA":[74,195],"deployments.":[75],"METHODS:":[76],"During":[77],"36-week":[79],"period,":[81,141,166],"we":[82],"systematically":[83],"documented":[84],"response":[86,106,157,177],"patterns":[87],"178":[89],"physician":[90,137],"users":[91],"randomized":[92],"receive":[94],"CTAs":[95],"for":[96,162],"an":[97],"ongoing":[98],"trial.":[100],"Data":[101],"were":[102,123,214],"collected":[103],"on:":[104],"(1)":[105],"rates":[107,114,148,158,178],"CTA;":[110],"(2)":[112],"referral":[113],"per":[115,117],"physician,":[116],"time":[118,140,165],"unit.":[119],"Variables":[120],"interest":[122],"offset":[124],"by":[125,135,160],"log":[127],"total":[130],"number":[131],"received":[134],"during":[138],"in":[142,180],"Poisson":[144],"regression.":[145],"RESULTS:":[146],"Response":[147],"significant":[151],"downward":[152],"trend":[153],"across":[154],"time,":[155],"with":[156],"decreasing":[159],"2.7%":[161],"each":[163],"advancing":[164],"significantly":[167],"different":[168],"from":[169],"zero":[170],"(flat)":[171],"(p<0.0001).":[172],"Even":[173],"after":[174,208],"36":[175,209],"weeks,":[176],"remained":[179,204],"30%-40%":[182],"range.":[183],"Subgroup":[184],"analyses":[185],"revealed":[186],"differences":[187,217],"between":[188,218],"community-based":[189,219],"versus":[190,220],"university-based":[191,221],"physicians":[192],"(p=0.0489).":[193],"DISCUSSION:":[194],"declined":[197],"gradually":[198],"over":[199],"prolonged":[200],"exposure,":[201],"although":[202],"it":[203],"reasonably":[205],"high":[206],"even":[207],"weeks":[210],"exposure.":[212],"There":[213],"also":[215],"notable":[216],"users.":[222],"CONCLUSIONS:":[223],"These":[224],"findings":[225],"add":[226],"limited":[229],"literature":[230],"on":[231],"this":[232],"form":[233],"EHR-based":[235],"alert":[236],"fatigue":[237],"should":[239],"help":[240],"tailoring,":[243],"deployment,":[244],"further":[246]},"counts_by_year":[{"year":2026,"cited_by_count":4},{"year":2025,"cited_by_count":10},{"year":2024,"cited_by_count":16},{"year":2023,"cited_by_count":22},{"year":2022,"cited_by_count":20},{"year":2021,"cited_by_count":16},{"year":2020,"cited_by_count":17},{"year":2019,"cited_by_count":18},{"year":2018,"cited_by_count":18},{"year":2017,"cited_by_count":10},{"year":2016,"cited_by_count":8},{"year":2015,"cited_by_count":15},{"year":2014,"cited_by_count":18},{"year":2013,"cited_by_count":5},{"year":2012,"cited_by_count":2}],"updated_date":"2026-06-13T07:54:00.901334","created_date":"2025-10-10T00:00:00"}