The impact of a diagnostic decision support system on the consultation: perceptions of GPs and patients

BMC Medical Informatics and Decision Making

Volumn 17, Issue 1, 2017, Pages

  Porat, Talya ^a   Delaney, Brendan ^b   Kostopoulou, Olga ^b  

^a KING'S COLLEGE LONDON   (United Kingdom)

^b IMPERIAL COLLEGE LONDON   (United Kingdom)

Author keywords

Acceptability; Cognitive engineering; Decision support systems; Diagnosis; Diagnostic error; Electronic health record; Patient satisfaction; Usability; Usefulness

Indexed keywords

ADOPTION; CHECKLIST; CLINICAL ARTICLE; COMPUTER INTERFACE; CONSULTATION; DECISION SUPPORT SYSTEM; DIAGNOSIS; DIAGNOSTIC ACCURACY; DIAGNOSTIC ERROR; DIAGNOSTIC TEST ACCURACY STUDY; DOCTOR PATIENT RELATION; ELECTRONIC HEALTH RECORD; FEMALE; GENERAL PRACTITIONER; HUMAN; MALE; PATIENT SATISFACTION; PERCEPTION; QUESTIONNAIRE; SYMPTOM; ADULT; CLINICAL DECISION SUPPORT SYSTEM; HEALTH SERVICES RESEARCH; PATIENT REFERRAL; STANDARDS;

ADULT; DECISION SUPPORT SYSTEMS, CLINICAL; ELECTRONIC HEALTH RECORDS; GENERAL PRACTITIONERS; HEALTH SERVICES RESEARCH; HUMANS; REFERRAL AND CONSULTATION;

EID: 85020004707     PISSN: None     EISSN: 14726947     Source Type: Journal    
DOI: 10.1186/s12911-017-0477-6     Document Type: Article

References (41)

1. Varonen H, Kortteisto T, Kaila M, EBMeDS Study Group. What may help or hinder the implementation of computerized decision support systems (CDSSs): a focus group study with physicians. Fam Pract. 2008;25(3):162-7.
2. Short D, Frischer M, Bashford J. Barriers to the adoption of computerised decision support systems in general practice consultations: a qualitative study of GPs’ perspectives. Int J Med Inform. 2004;73(4):357-62.
3. Kawamoto K, Del Fiol G. Clinical decision support systems in healthcare. In: Nelson R, Staggers N, editors. Health informatics: an interprofessional approach. Elsevier; 2017. 15. p.170-183.
4. Ramnarayan P, Kapoor RR, Coren M, Nanduri V, Tomlinson AL, Taylor PM, et al. Measuring the impact of diagnostic decision support on the quality of clinical decision making: development of a reliable and valid composite score. J Am Med Inform Assoc. 2003;10(6):563-72.
5. van Rosse F, Maat B, Rademaker CM, van Vught AJ, Egberts AC, Bollen CW. The effect of computerized physician order entry on medication prescription errors and clinical outcome in pediatric and intensive care: a systematic review. Pediatrics. 2009;123(4):1184-90.
6. Kostopoulou O, Porat T, Corrigan D, Mahmoud S, Delaney BC. Diagnostic accuracy of GPs when using an early intervention decision support system: a high-fidelity simulation. Br J Gen Pract. 2017. doi: 10.3399/bjgp16X688417.
7. Bright TJ, Wong A, Dhurjati R, Bristow E, Bastian L, et al. Effect of clinical decision-support systems a systematic review. Ann Intern Med. 2012;157(1):29-43.
8. Shibl R, Lawley M, Debuse J. Factors influencing decision support system acceptance. Decis Support Syst. 2013;54:953-61.
9. Musen MA, Middleton B, Greenes RA. Clinical decision-support systems. In: Shortliffe EH, Cimino JJ, editors. Biomedical informatics. London: Springer; 2014. p. 643-74.
10. Chana N, Porat T, Whittlesea C, Delaney B. Improving specialist drug prescribing in primary care using task and error analysis. Br J Gen Pract. 2017;67:e157.
11. Sidebottom AC, Collins B, Winden TJ, Knutson A, Britt HR. Reactions of nurses to the use of electronic health record alert features in an inpatient setting. Comput Inform Nurs. 2012;30(4):218-26.
12. Wu HW, Davis PK, Bell DS. Advancing clinical decision support using lessons from outside of healthcare: an interdisciplinary systematic review. BMC Med Inform Decis Mak. 2012;12(1):90.
13. Tawfik H, Anya O, Nagar AK. Understanding clinical work practices for cross-boundary decision support in e-health. IEEE Trans Inf Technol Biomed. 2012;16(4):530-41.
14. Nurek M, Kostopoulou O, Delaney BC, Esmail A. Reducing diagnostic errors in primary care. A systematic meta-review of computerized diagnostic decision support systems by the LINNEAUS collaboration on patient safety in primary care. Eur J Gen Pract. 2015;21(sup1):8-13.
15. Jaspers MW, Smeulers M, Vermeulen H, Peute LW. Effects of clinical decision-support systems on practitioner performance and patient outcomes: a synthesis of high-quality systematic review findings. J Am Med Inform Assoc. 2011;18(3):327-34.
16. Dawes RM, Faust D, Meehl PE. Clinical versus actuarial judgment. Science. 1989;243(4899):1668-74.
17. Mollon B, Chong JJ, Holbrook AM, Sung M, Thabane L, Foster G. Features predicting the success of computerized decision support for prescribing: a systematic review of randomized controlled trials. BMC Med Inform Decis Mak. 2009;9(1):11.
18. Arkes HR, Shaffer VA, Medow MA. Patients derogate physicians who use a computer-assisted diagnostic aid. Med Decis Making. 2007;27:189-202.
19. Shaffer VA, Probst CA, Merkle EC, Arkes HR, Medow MA. Why do patients derogate physicians who use a computer-based- diagnostic support system? Med Decis Making. 2013;33(1):108-18.
20. Kostopoulou O, Lionis C, Angelaki A, Ayis S, Durbaba S, Delaney BC. Early diagnostic suggestions improve accuracy of family physicians: a randomized controlled trial in Greece. Fam Pract. 2015;32(3):323-8. doi:10.1093/fampra/cmv012.
21. Kostopoulou O, Rosen A, Round T, Wright E, Douiri A, Delaney BC. Early diagnostic suggestions improve accuracy of GPs: a randomised controlled trial using computer-simulated patients. Br J Gen Pract. 2015;65(630):e49-54.
22. Porat T, Kostopoulou O, Woolley A, Delaney BC. Eliciting user decision requirements for designing computerized diagnostic support for family physicians. J Cogn Eng Decis Making. 2016;10(1):57-73.
23. Miller A, Militello L. The role of cognitive engineering in improving clinical decision support. In: Bisantz AM, Burns CM, Fairbanks RJ, editors. Cognitive systems engineering in health care. Taylor & Francis Group; 2014. p. 7-26.
24. Hettinger AZ, Roth E, Bisantz AM. Cognitive engineering and health informatics: applications and intersections. J Biomed Inform. 2017;67:21.
25. Lewis JR. IBM computer usability satisfaction questionnaires: Psychometric evaluation and instructions for use. Int J Hum Comput Interact. 1995;7(1):57-78.
26. Lewis JR. Psychometric evaluation of the PSSUQ using data from five years of usability studies. Int J Hum Comput Interact. 2002;14(3&4):463-88.
27. Baker R. Development of a questionnaire to assess patients’ satisfaction with consultations in general practice. Br J Gen Pract. 1990;40(341):487-90.
28. Baker R, Whitfield M. Measuring patient satisfaction: a test of construct validity. Qual Saf Health Care. 1992;1(2):104-9.
29. Poulton BC. Use of the consultation satisfaction questionnaire to examine patients’ satisfaction with general practitioners and community nurses: reliability, replicability and discriminant validity. Br J Gen Pract. 1996;46(402):26-31.
30. Kinnersley P, Stott N, Peters T, Harvey I, Hackett P. A comparison of methods for measuring patient satisfaction with consultations in primary care. Fam Pract. 1996;13(1):41-51. doi:10.1093/fampra/13.1.41.
31. Braun V, Clarke V. Using thematic analysis in psychology. Qual Res Psychol. 2006;3(2):77-101.
32. Lu HP, Gustafson DH. An empirical study of perceived usefulness and perceived ease of use on computerized support system use over time. Int J Inf Manag. 1994;14(5):317-29.
33. Venkatesh V, Morris MG, Davis GB, Davis FD. User acceptance of information technology: Toward a unified view. MIS Quart. 2003;425-478.
34. Stokes K, Barker R, Pigott R. Which doctors take up promising ideas? New insights from open data. Nesta, 2014 online: https://www.nesta.org.uk/sites/default/files/which_doctors_take_up_promising.pdf. Accessed 29 Jan 2017.
35. Hsu J, Huang J, Fung V, Robertson N, Jimison H, Frankel R. Health information technology and physician-patient interactions: impact of computers on communication during outpatient primary care visits. J Am Med Inform Assoc. 2005;12(4):474-80.
36. Nielsen J. Why you only need to test with 5 users: Alertbox 2000. https://www.nngroup.com/articles/why-you-only-need-to-test-with-5-users/. Accessed 29 Jan 2017.
37. Das J, Kwan A, Daniels B, Satyanarayana S, Subbaraman R, et al. Use of standardised patients to assess quality of tuberculosis care: a pilot, cross-sectional study. Lancet Infect Dis. 2015;15(11):1305-13.
38. Badger LW, DeGruy F, Hartman J, Plant MA, Leeper J, Ficken R, … & Nutt L. Stability of standardized patients’ performance in a study of clinical decision making. Fam Med. 1995;27(2):126-131.
39. Pieters HM, Touw-Otten FWWM, De Melker RD. Simulated patients in assessing consultation skills of trainees in general practice vocational training: a validity study. Med Educ. 1994;28(3):226-33.
40. Rethans JJ, Van Boven CP. Simulated patients in general practice: a different look at the consultation. Br Med J (Clin Res Ed). 1987;294(6575):809-12.
41. Evans SC, Roberts MC, Keeley JW, Blossom JB, Amaro CM, Garcia AM, … & Reed GM. Vignette methodologies for studying clinicians’ decision-making: validity, utility, and application in ICD-11 field studies. Int J Clin Health Psychol. 2015;15(2):160-170.