Physicians' Attitudes Towards the Advice of a Guideline-Based Decision Support System: A Case Study with OncoDoc2 in the Management of Breast Cancer Patients

Jacques Bouaud, Jean Philippe Spano, Jean Pierre Lefranc, Isabelle Cojean-Zelek, Brigitte Blaszka-Jaulerry, Laurent Zelek, Axel Durieux, Christophe Tournigand, Alexandra Rousseau, Pierre Yves Vandenbussche, Brigitte Séroussi

Research output: Chapter in Book/Report/Conference proceedingConference contributionpeer-review

14 Scopus citations

Abstract

When wrongly used, guideline-based clinical decision support systems (CDSSs) may generate inappropriate propositions that do not match the recommendations provided by clinical practice guidelines (CPGs). The user may decide to comply with or react to the CDSS, and her decision may finally comply or not with CPGs. OncoDoc2 is a guideline-based CDSS for breast cancer management. We collected 394 decisions made by multidisciplinary meeting physicians in three hospitals where the CDSS was evaluated. We observed a global CPG compliance of 86.8% and a global CDSS compliance of 75.4%. Non-CPG compliance was observed in case of a negative reactance to the CDSS, when users did not follow a correct CDSS proposition (8.6% of decisions). Because of errors in patient data entry, OncoDoc2 delivered non-recommended propositions in 21.3% of decisions, leading to compliances with CDSS and CPGs of respectively 21.4% and 65.5%, whereas both compliances exceeded 90% when CDSS advices included CPG recommendations. Automation bias, when users followed an incorrect CDSS proposition explained the remaining non-compliance with CPGs (4.6% of decisions). Securing the use of CDSSs is of major importance to warranty patient safety and benefit of their potential to improve care.

Original languageEnglish
Title of host publicationMEDINFO 2015
Subtitle of host publicationeHealth-Enabled Health - Proceedings of the 15th World Congress on Health and Biomedical Informatics
EditorsAndrew Georgiou, Indra Neil Sarkar, Paulo Mazzoncini de Azevedo Marques
PublisherIOS Press
Pages264-269
Number of pages6
ISBN (Electronic)9781614995630
DOIs
StatePublished - 2015
Externally publishedYes
Event15th World Congress on Health and Biomedical Informatics, MEDINFO 2015 - Sao Paulo, Brazil
Duration: Aug 19 2015Aug 23 2015

Publication series

NameStudies in Health Technology and Informatics
Volume216
ISSN (Print)0926-9630
ISSN (Electronic)1879-8365

Conference

Conference15th World Congress on Health and Biomedical Informatics, MEDINFO 2015
Country/TerritoryBrazil
CitySao Paulo
Period08/19/1508/23/15

Keywords

  • Attitude to Computers
  • Breast cancer management
  • Clinical decision support systems
  • Guideline adherence

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