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Randomised controlled trial
An ‘e-Nudge’ electronic reminder system that highlights individuals at raised cardiovascular risk encourages GPs to improve the collection of patient cardiovascular risk factor data
  1. David W Bates
  1. Brigham and Women's Hospital, Brigham Circle, Boston, Massachusetts, USA
  1. Correspondence to David W Bates
    Brigham and Women's Hospital, Brigham Circle, 1620 Tremont Street, 3rd Floor, Boston, MA 02120-1613, USA; dbates{at}

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Electronic health records (EHRs) are widely used, and one of the hoped-for benefits has been improved quality of care, but actual performance has been spotty. In particular, clinicians have often failed to consider clinical risk when dealing with individual patients.


The authors performed a randomised controlled trial in which they assessed the impact of electronic reminders aimed at increasing primary care physician awareness of primary cardiovascular risk, and assessed physician awareness and the number of cardiovascular events in a primary care population. Altogether, 38 000 patients aged 50 and older were randomised. The intervention was a tool called the e-Nudge which searches electronic records for risk factor data and stratifies patients into four groups (A–D). …

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  • Competing interests None.