TY - GEN
T1 - Physicians' Attitudes Towards the Advice of a Guideline-Based Decision Support System
T2 - 15th World Congress on Health and Biomedical Informatics, MEDINFO 2015
AU - Bouaud, Jacques
AU - Spano, Jean Philippe
AU - Lefranc, Jean Pierre
AU - Cojean-Zelek, Isabelle
AU - Blaszka-Jaulerry, Brigitte
AU - Zelek, Laurent
AU - Durieux, Axel
AU - Tournigand, Christophe
AU - Rousseau, Alexandra
AU - Vandenbussche, Pierre Yves
AU - Séroussi, Brigitte
N1 - Publisher Copyright:
© 2015 IMIA and IOS Press.
PY - 2015
Y1 - 2015
N2 - 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.
AB - 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.
KW - Attitude to Computers
KW - Breast cancer management
KW - Clinical decision support systems
KW - Guideline adherence
UR - http://www.scopus.com/inward/record.url?scp=84951943988&partnerID=8YFLogxK
U2 - 10.3233/978-1-61499-564-7-264
DO - 10.3233/978-1-61499-564-7-264
M3 - Contribución a la conferencia
C2 - 26262052
AN - SCOPUS:84951943988
T3 - Studies in Health Technology and Informatics
SP - 264
EP - 269
BT - MEDINFO 2015
A2 - Georgiou, Andrew
A2 - Sarkar, Indra Neil
A2 - de Azevedo Marques, Paulo Mazzoncini
PB - IOS Press
Y2 - 19 August 2015 through 23 August 2015
ER -