• Medientyp: E-Artikel
  • Titel: Impact of a Computer-Based Diagnostic Decision Support Tool on the Differential Diagnoses of Medicine Residents
  • Beteiligte: Feldman, Mitchell J.; Hoffer, Edward P.; Barnett, G. Octo; Kim, Richard J.; Famiglietti, Kathleen T.; Chueh, Henry C.
  • Erschienen: Journal of Graduate Medical Education, 2012
  • Erschienen in: Journal of Graduate Medical Education, 4 (2012) 2, Seite 227-231
  • Sprache: Englisch
  • DOI: 10.4300/jgme-d-11-00180.1
  • ISSN: 1949-8357; 1949-8349
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  • Beschreibung: Abstract Background Computer-based medical diagnostic decision support systems have been used for decades, initially as stand-alone applications. More recent versions have been tested for their effectiveness in enhancing the diagnostic ability of clinicians. Objective To determine if viewing a rank-ordered list of diagnostic possibilities from a medical diagnostic decision support system improves residents' differential diagnoses or management plans. Method Twenty first-year internal medicine residents at Massachusetts General Hospital viewed 3 deidentified case descriptions of real patients. All residents completed a web-based questionnaire, entering the differential diagnosis and management plan before and after seeing the diagnostic decision support system's suggested list of diseases. In all 3 exercises, the actual case diagnosis was first on the system's list. Each resident served as his or her own control (pretest/posttest). Results For all 3 cases, a substantial percentage of residents changed their primary considered diagnosis after reviewing the system's suggested diagnoses, and a number of residents who had not initially listed a “further action” (laboratory test, imaging study, or referral) added or changed their management options after using the system. Many residents (20% to 65% depending on the case) improved their differential diagnosis from before to after viewing the system's suggestions. The average time to complete all 3 cases was 15.4 minutes. Most residents thought that viewing the medical diagnostic decision support system's list of suggestions was helpful. Conclusion Viewing a rank-ordered list of diagnostic possibilities from a diagnostic decision support tool had a significant beneficial effect on the quality of first-year medicine residents' differential diagnoses and management plans.
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