ArticleBMJ quality & safety2020
Application of human factors to improve usability of clinical decision support for diagnostic decision-making: a scenario-based simulation study.
Article in BMJ quality & safety, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 37 papers, 2 of them syntheses that pooled it.
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
37 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Examining Mental Workload Relating to Digital Health Technologies in Health Care: Systematic Review.Journal of medical Internet research · 2022Pooled it
- Dashboards for visual display of patient safety data: a systematic review.BMJ health & care informatics · 2021Pooled it
- Exposure to clinical decision support and training increases primary care clinician confidence in managing cognitive impairment care but not confidence to diagnose.BMC primary care · 2025Trial
- Evaluating the impact of a BOPPPS and scenario-based simulation intervention on the competency of junior circulating nurses: a quasi-experimental study.BMC medical education · 2026Article
- Treatment Recommendations for Clinical Deterioration on the Wards: Development and Validation of Machine Learning Models.JMIR AI · 2026Article
- Understanding Clinical Decision Support Failures in Pediatric Intensive Care Units via Applied Systems Safety Engineering and Human Factors Problem Analysis: Insights From the DISCOVER Learning Lab.Journal of patient safety · 2025Article
- A Novel Playbook for Pragmatic Trial Operations to Monitor and Evaluate Ambient Artificial Intelligence in Clinical Practice.NEJM AI · 2025Article
- Design approaches for developing quality checklists in healthcare organizations: A scoping review.PLOS digital health · 2025Article
- A Novel Playbook for Pragmatic Trial Operations to Monitor and Evaluate Ambient Artificial Intelligence in Clinical Practice.medRxiv : the preprint server for health sciences · 2025Article
- A Measurement Science Framework to Optimize CDS for Opioid Use Disorder Treatment in the ED.Applied clinical informatics · 2025Article
- Clinical implementation of AI-based screening for risk for opioid use disorder in hospitalized adults.Nature medicine · 2025Observational
- The value of simulation testing for the evaluation of ambient digital scribes: a case report.Journal of the American Medical Informatics Association : JAMIA · 2025Article
- Editorial: Overcoming challenges in health technology implementation to maximize patient safety.Frontiers in health services · 2025Article
- Factors Guiding Clinical Decision-Making in Genitourinary Oncology.Cancer medicine · 2024Review
- Human factors methods in the design of digital decision support systems for population health: a scoping review.BMC public health · 2024Article
- Exploring research and education opportunities in digital health for pharmacy, medicine and other health disciplines: Insights from a multinational workshop.Exploratory research in clinical and social pharmacy · 2024Article
- Nurses' perceptions of the design, implementation, and adoption of machine learning clinical decision support: A descriptive qualitative study.Journal of nursing scholarship : an official publication of Sigma Theta Tau International Honor Society of Nursing · 2024Article
- Academic Detailing as a Health Information Technology Implementation Method: Supporting the Design and Implementation of an Emergency Department-Based Clinical Decision Support Tool to Prevent Future Falls.JMIR human factors · 2024Article
- How to co-design a prototype of a clinical practice tool: a framework with practical guidance and a case study.BMJ quality & safety · 2024Article
- Usability of a Human Factors-based Clinical Decision Support in the Emergency Department: Lessons Learned for Design and Implementation.Human factors · 2024Article
Corrections and comments
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Authors and funding
12 authors.
Funding
Abstract
objectiveIn this study, we used human factors (HF) methods and principles to design a clinical decision support (CDS) that provides cognitive support to the pulmonary embolism (PE) diagnostic decision-making process in the emergency department. We hypothesised that the application of HF methods and principles will produce a more usable CDS that improves PE diagnostic decision-making, in particular decision about appropriate clinical pathway. MATERIALS AND
methodsWe conducted a scenario-based simulation study to compare a HF-based CDS (the so-called CDS for PE diagnosis (PE-Dx CDS)) with a web-based CDS (MDCalc); 32 emergency physicians performed various tasks using both CDS. PE-Dx integrated HF design principles such as automating information acquisition and analysis, and minimising workload. We assessed all three dimensions of usability using both objective and subjective measures: effectiveness (eg, appropriate decision regarding the PE diagnostic pathway), efficiency (eg, time spent, perceived workload) and satisfaction (perceived usability of CDS).
resultsEmergency physicians made more appropriate diagnostic decisions (94% with PE-Dx; 84% with web-based CDS; p<0.01) and performed experimental tasks faster with the PE-Dx CDS (on average 96 s per scenario with PE-Dx; 117 s with web-based CDS; p<0.001). They also reported lower workload (p<0.001) and higher satisfaction (p<0.001) with PE-Dx.
conclusionsThis simulation study shows that HF methods and principles can improve usability of CDS and diagnostic decision-making. Aspects of the HF-based CDS that provided cognitive support to emergency physicians and improved diagnostic performance included automation of information acquisition (eg, auto-populating risk scoring algorithms), minimisation of workload and support of decision selection (eg, recommending a clinical pathway). These HF design principles can be applied to the design of other CDS technologies to improve diagnostic safety.
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Registered trials
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.