- Design
- Multicentre, parallel-group randomised pilot (MAESTRI), Germany
- Population
- 43 adults at increased risk of inflammatory rheumatic disease in rheumatology, dermatology and orthopaedic clinics
- Primary outcome
- Documentation completeness of predefined screening items, blinded review
- Effect
- Median 100% vs 46.9% (p < 0.001)
The MAESTRI pilot randomised 43 adults at increased risk of an inflammatory rheumatic disease, attending rheumatology, dermatology or orthopaedic outpatient services in Germany, to a pre-visit computer-assisted history with a copy-ready summary or to usual care. The primary outcome was how many predefined screening-relevant items appeared in the final clinical note, assessed by a blinded reviewer.
Median completeness was 100% (IQR 100 to 100) with the tool against 46.9% (IQR 10.0 to 68.8) with usual care (p < 0.001), consistently across the three specialties. Of the 43 patients, 41 (95.3%) were willing to complete the questionnaire and all six responding physicians were willing to offer it again.
The outcome measures documentation and not detection, diagnosis or time saved. It suggests a workable approach for a short consultation, and a larger trial would need to test whether it changes referral accuracy or workload.
- Documentation completeness was a median 100% with pre-visit history-taking against 46.9% with usual care.
- 95.3% of patients were willing to complete the questionnaire.
- The study had 43 patients and 6 responding physicians.
- It measured the content of notes, not diagnoses or outcomes.
- Digital questionnaires were seen as a complement to, not a replacement for, the consultation.
Why it matters
Missing history is a common reason for delayed referral, and a structured summary targets that cheaply.
Don't overread it
A 43-patient pilot with a documentation endpoint cannot show better diagnosis, referral or patient outcomes.
The statistics, in plain English
A median of 100% with an interquartile range of 100 to 100 means at least three quarters of the intervention notes were fully complete. The control notes ranged widely. The small sample means the precise size of the gain is uncertain.
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