Document Detail


Evaluation of a computerized diagnostic decision support system for patients with pneumonia: study design considerations.
MedLine Citation:
PMID:  11522768     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Planning the clinical evaluation of a computerized decision support system requires a strategy that encompasses the different aspects of the clinical problem, the technical difficulties of software and hardware integration and implementation, the behavioral aspects of the targeted users, and the discipline of study design. Although clinical information systems are becoming more widely available, only a few decision support systems have been formally evaluated in clinical environments. Published accounts of difficulties associated with the clinical evaluation of decision support systems remain scarce. The authors report on a variety of behavioral, logistical, technical, clinical, cost, and work flow issues that they had to address when choosing a study design for a clinical trial for the evaluation of an integrated, real-time decision support system for the automatic identification of patients likely to have pneumonia in an emergency department. In the absence of a true gold standard, they show how they created a credible, clinically acceptable, and economical reference standard for the diagnosis of pneumonia, to determine the overall accuracy of the system. For the creation of a reference standard, they describe the importance of recognizing verification bias and avoiding it. Finally, advantages and disadvantages of different study designs are explored with respect to the targeted users and the clinical setting.
Authors:
D Aronsky; K J Chan; P J Haug
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Journal of the American Medical Informatics Association : JAMIA     Volume:  8     ISSN:  1067-5027     ISO Abbreviation:  J Am Med Inform Assoc     Publication Date:    2001 Sep-Oct
Date Detail:
Created Date:  2001-08-27     Completed Date:  2001-10-04     Revised Date:  2013-04-18    
Medline Journal Info:
Nlm Unique ID:  9430800     Medline TA:  J Am Med Inform Assoc     Country:  United States    
Other Details:
Languages:  eng     Pagination:  473-85     Citation Subset:  IM    
Affiliation:
Department of Biomedical Informatics, Informatics Center, Eskind Library, Vanderbilt University, Nashville, Tennessee 37232-8340, USA. dominik.aronsky@mcmail.vanderbilt.edu
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MeSH Terms
Descriptor/Qualifier:
Cross-Over Studies
Decision Support Systems, Clinical* / standards
Emergencies
Emergency Service, Hospital
Evaluation Studies as Topic*
Humans
Pneumonia / diagnosis*
Prevalence
Reference Standards
Research Design
Comments/Corrections

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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