Berner ES et al. 1999 "Effects of a decision support system on physicians' diagnostic performance."
Reference
Berner ES, Maisiak RS, Cobbs CG, et al. Effects of a decision support system on physicians' diagnostic performance. J Am Med Inform Assoc 1999;6(5):420-427.
Abstract
"Purpose: This study examines how the information provided by a diagnostic decision support system for clinical cases of varying diagnostic difficulty affects physicians' diagnostic performance. Methods: A national sample of 67 internists, 35 family physicians, and 6 other physicians used the...diagnostic decision support system to assist them in the diagnosis of written clinical cases. Three sets of eight cases, stratified by diagnostic difficulty and the potential of [the system] to produce high-quality information, were used. The effects of using [the system] on three measures of physicians' diagnostic performance were analyzed using analyses of variance. Results: Physicians' diagnostic performance was significantly higher (p < 0.01) on the easier cases and the cases for which [DDSS] could provide higher-quality information. Conclusions: Physicians' diagnostic performance can be strongly influenced by the quality of information the system produces and the type of cases on which the system is used."
Objective
To examine "how the information provided by a diagnostic decision support system for clinical cases of varying diagnostic difficulty affects physicians' diagnostic performance."
Size
not applicable
Type of Health IT
Decision support system
Type of Health IT Functions
The diagnostic decision support system (DDSS) used in this study was capable of providing information on more than 650 internal medicine disorders. The primary function of note in this study was the "case analysis" function of the DDSS. The physicians entered information about the case (history, physical, and basic laboratory data) into the system, and the system output a list of possible diagnoses.
Workflow-Related Findings
"The better performance overall, and the higher accuracy scores in particular, on the [cases for which the system performed better in a previous study] suggest that the DDSS served a prompting function by reminding physicians of the correct diagnoses on these cases." Other data also suggested that this prompting was occurring and that it was effective in aiding physicians to arrive at the right diagnosis.
"The quality of the information displayed by the DDSS influenced physicians' performance." Performance was likely to be better for cases where the DDSS was displaying higher quality information.
The physicians were more likely to select the correct diagnosis when the DDSS displayed it.
"Physicians can utilize helpful DDSS suggestions even when other irrelevant suggestions are also provided."
Study Design
Only postintervention (no control group)
Study Participants
Test cases were completed by 108 participants, and 107 of these returned usable data.