ArticleBMC medical informatics and decision making2015
Understanding complex clinical reasoning in infectious diseases for improving clinical decision support design.
Article in BMC medical informatics and decision making, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 31 papers, 3 of them syntheses that pooled it.
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Who cites it
31 citing papers in PubMed, 3 syntheses or guidelines pooled it.
- The role of information systems in emergency department decision-making-a literature review.Journal of the American Medical Informatics Association : JAMIA · 2024Pooled it
- How Do Contexts Affect Physicians' Clinical Reasoning? A Narrative Review.MedEdPublish (2016) · 2020Pooled it
- Novel displays of patient information in critical care settings: a systematic review.Journal of the American Medical Informatics Association : JAMIA · 2019Pooled it
- Automated symptom and treatment side effect monitoring for improved quality of life among adults with diabetic peripheral neuropathy in primary care: a pragmatic, cluster, randomized, controlled trial.Diabetic medicine : a journal of the British Diabetic Association · 2019Trial
- What aspects of clinical uncertainty are addressed by published competencies in evidence-based medicine? A scoping review.BMJ open · 2026Article
- Antibiotic prescribing practices, perceived constraints, and views on antimicrobial resistance among general and orthopedic surgeons in central India.Scientific reports · 2025Article
- Post-Quantum Cryptography Resilience in Telehealth Using Quantum Key Distribution.Blockchain in healthcare today · 2025Article
- "What brought you in today?": Modeling patient-provider clinic visits to characterize rural providers' antibiotic treatment decisions.Research in social & administrative pharmacy : RSAP · 2023Article
- Artificial Intelligent Context-Aware Machine-Learning Tool to Detect Adverse Drug Events from Social Media Platforms.Journal of medical toxicology : official journal of the American College of Medical Toxicology · 2022Article
- Article
- Investigating pharmacy students' therapeutic decision-making with respect to antimicrobial stewardship cases.BMC medical education · 2022Article
- Ground truth labels challenge the validity of sepsis consensus definitions in critical illness.Journal of translational medicine · 2022Article
- Scoping review: the empowerment of Alzheimer's Disease caregivers with mHealth applications.NPJ digital medicine · 2021Article
- Life or limb: an international qualitative study on decision making in sarcoma surgery during the COVID-19 pandemic.BMJ open · 2021Article
- Pharmacogenomics cascade testing (PhaCT): a novel approach for preemptive pharmacogenomics testing to optimize medication therapy.The pharmacogenomics journal · 2021Review
- Simulated Adoption of 2019 Community-Acquired Pneumonia Guidelines Across 114 Veterans Affairs Medical Centers: Estimated Impact on Culturing and Antibiotic Selection in Hospitalized Patients.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2021Article
- Use of Acute Psychiatric Hospitalisation: A Study of the Factors Influencing Decisions to Arrange Acute Admission to Inpatient Mental Health Facilities.Frontiers in psychiatry · 2021Article
- Artificial Intelligence-Powered Smartphone App to Facilitate Medication Adherence: Protocol for a Human Factors Design Study.JMIR research protocols · 2020Article
- Choice and consequence: A naturalistic analysis of least-worst decision-making in critical incidents.Memory & cognition · 2020Article
- ENHANCING USEFULNESS AND USABILITY OF A CLINICAL DECISION SUPPORT PROTOTYPE FOR ANTIBIOTIC STEWARDSHIP.Proceedings of the International Symposium of Human Factors and Ergonomics in Healthcare. International Symposium of Human Factors and Ergonomics in Healthcare · 2020Article
Corrections and comments
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Authors and funding
5 authors.
Funding
Abstract
backgroundClinical experts' cognitive mechanisms for managing complexity have implications for the design of future innovative healthcare systems. The purpose of the study is to examine the constituents of decision complexity and explore the cognitive strategies clinicians use to control and adapt to their information environment.
methodsWe used Cognitive Task Analysis (CTA) methods to interview 10 Infectious Disease (ID) experts at the University of Utah and Salt Lake City Veterans Administration Medical Center. Participants were asked to recall a complex, critical and vivid antibiotic-prescribing incident using the Critical Decision Method (CDM), a type of Cognitive Task Analysis (CTA). Using the four iterations of the Critical Decision Method, questions were posed to fully explore the incident, focusing in depth on the clinical components underlying the complexity. Probes were included to assess cognitive and decision strategies used by participants.
resultsThe following three themes emerged as the constituents of decision complexity experienced by the Infectious Diseases experts: 1) the overall clinical picture does not match the pattern, 2) a lack of comprehension of the situation and 3) dealing with social and emotional pressures such as fear and anxiety. All these factors contribute to decision complexity. These factors almost always occurred together, creating unexpected events and uncertainty in clinical reasoning. Five themes emerged in the analyses of how experts deal with the complexity. Expert clinicians frequently used 1) watchful waiting instead of over- prescribing antibiotics, engaged in 2) theory of mind to project and simulate other practitioners' perspectives, reduced very complex cases into simple 3) heuristics, employed 4) anticipatory thinking to plan and re-plan events and consulted with peers to share knowledge, solicit opinions and 5) seek help on patient cases.
conclusionThe cognitive strategies to deal with decision complexity found in this study have important implications for design future decision support systems for the management of complex patients.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.