ArticleJournal of the American Medical Informatics Association : JAMIA
Measuring the impact of diagnostic decision support on the quality of clinical decision making: development of a reliable and valid composite score.
Article in Journal of the American Medical Informatics Association : JAMIA. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers.
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Who cites it
20 citing papers in PubMed.
- Can clinical decision support systems be an asset in medical education? An experimental approach.BMC medical education · 2023Trial
- Early diagnostic suggestions improve accuracy of GPs: a randomised controlled trial using computer-simulated patients.The British journal of general practice : the journal of the Royal College of General Practitioners · 2015Trial
- Assessing the Performance of a New Artificial Intelligence-Driven Diagnostic Support Tool Using Medical Board Exam Simulations: Clinical Vignette Study.JMIR medical informatics · 2021Article
- Improving Team-Based Decision Making Using Data Analytics and Informatics: Protocol for a Collaborative Decision Support Design.JMIR research protocols · 2019Article
- A review of measurement practice in studies of clinical decision support systems 1998-2017.Journal of the American Medical Informatics Association : JAMIA · 2019Review
- The Effect of Pet Therapy and Artist Interactions on Quality of Life in Brain Tumor Patients: A Cross-Section of Art and Medicine in Dialog.Behavioral sciences (Basel, Switzerland) · 2018Article
- Adverse event detection by medical record review is reproducible, but the assessment of their preventability is not.PloS one · 2018Article
- The impact of a diagnostic decision support system on the consultation: perceptions of GPs and patients.BMC medical informatics and decision making · 2017Article
- Evidence-based decision support for pediatric rheumatology reduces diagnostic errors.Pediatric rheumatology online journal · 2016Article
- Comparative outcome studies of clinical decision support software: limitations to the practice of evidence-based system acquisition.Journal of the American Medical Informatics Association : JAMIA · 2015Article
- Evidence-based decision support for neurological diagnosis reduces errors and unnecessary workup.Journal of child neurology · 2014Article
- Use of health information technology to reduce diagnostic errors.BMJ quality & safety · 2013Review
- Using value of information to guide evaluation of decision supports for differential diagnosis: is it time for a new look?BMC medical informatics and decision making · 2013Article
- Beyond the threshold: real-time use of evidence in practice.BMC medical informatics and decision making · 2013Article
- Biomedical informatics for computer-aided decision support systems: a survey.TheScientificWorldJournal · 2013Review
- Impact of a computer-based diagnostic decision support tool on the differential diagnoses of medicine residents.Journal of graduate medical education · 2012Article
- Diagnostic omission errors in acute paediatric practice: impact of a reminder system on decision-making.BMC medical informatics and decision making · 2006Article
- Assessment of the potential impact of a reminder system on the reduction of diagnostic errors: a quasi-experimental study.BMC medical informatics and decision making · 2006Article
- Textual guidelines versus computable guidelines: a comparative study in the framework of the PRESGUID project in order to appreciate the impact of guideline format on physician compliance.AMIA ... Annual Symposium proceedings. AMIA Symposium · 2006Article
- Diagnostic decision support systems: how to determine the gold standard?Journal of the American Medical Informatics Association : JAMIAArticle
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8 authors.
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No grant is acknowledged in the PubMed record.
Abstract
objectiveFew previous studies evaluating the benefits of diagnostic decision support systems have simultaneously measured changes in diagnostic quality and clinical management prompted by use of the system. This report describes a reliable and valid scoring technique to measure the quality of clinical decision plans in an acute medical setting, where diagnostic decision support tools might prove most useful.
designSets of differential diagnoses and clinical management plans generated by 71 clinicians for six simulated cases, before and after decision support from a Web-based pediatric differential diagnostic tool (ISABEL), were used. MEASUREMENTS: A composite quality score was calculated separately for each diagnostic and management plan by considering the appropriateness value of each component diagnostic or management suggestion, a weighted sum of individual suggestion ratings, relevance of the entire plan, and its comprehensiveness. The reliability and validity (face, concurrent, construct, and content) of these two final scores were examined.
resultsTwo hundred fifty-two diagnostic and 350 management suggestions were included in the interrater reliability analysis. There was good agreement between raters (intraclass correlation coefficient, 0.79 for diagnoses, and 0.72 for management). No counterintuitive scores were demonstrated on visual inspection of the sets. Content validity was verified by a consultation process with pediatricians. Both scores discriminated adequately between the plans of consultants and medical students and correlated well with clinicians' subjective opinions of overall plan quality (Spearman rho 0.65, p < 0.01). The diagnostic and management scores for each episode showed moderate correlation (r = 0.51).
conclusionThe scores described can be used as key outcome measures in a larger study to fully assess the value of diagnostic decision aids, such as the ISABEL system.
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