Decision Making by Emergency Room Physicians and Residents

Author(s):  
Michael J. Hine ◽  
Ken J. Farion ◽  
Wojtek Michalowski ◽  
Szymon Wilk

Clinical Decision Support Systems (CDSS) are typically constructed from expert knowledge and are often reliant on inputs that are difficult to obtain and on tacit knowledge that only experienced clinicians possess. Research described in this article uses empirical results from a clinical trial of a CDSS with a decision model based on expert knowledge to show that there are differences in how clinician groups of the same specialty, but different level of expertise, elicit necessary CDSS input variables and use said variables in their clinical decisions. This article reports that novice clinicians have difficulty eliciting CDSS input variables that require physical examination, yet they still use these incorrectly elicited variables in making their clinical decisions. Implications for the design of CDSS are discussed.

2011 ◽  
pp. 1501-1519
Author(s):  
Michael J. Hine ◽  
Ken J. Farion ◽  
Wojtek Michalowski ◽  
Szymon Wilk

Clinical Decision Support Systems (CDSS) are typically constructed from expert knowledge and are often reliant on inputs that are difficult to obtain and on tacit knowledge that only experienced clinicians possess. Research described in this article uses empirical results from a clinical trial of a CDSS with a decision model based on expert knowledge to show that there are differences in how clinician groups of the same specialty, but different level of expertise, elicit necessary CDSS input variables and use said variables in their clinical decisions. This article reports that novice clinicians have difficulty eliciting CDSS input variables that require physical examination, yet they still use these incorrectly elicited variables in making their clinical decisions. Implications for the design of CDSS are discussed. [Article copies are available for purchase from InfoScion- Demand.com]


Author(s):  
Jan Kalina

The complexity of clinical decision-making is immensely increasing with the advent of big data with a clinical relevance. Clinical decision systems represent useful e-health tools applicable to various tasks within the clinical decision-making process. This chapter is devoted to basic principles of clinical decision support systems and their benefits for healthcare and patient safety. Big data is crucial input for clinical decision support systems and is helpful in the task to find the diagnosis, prognosis, and therapy. Statistical challenges of analyzing big data in psychiatry are overviewed, with a particular interest for psychiatry. Various barriers preventing telemedicine tools from expanding to the field of mental health are discussed. The development of decision support systems is claimed here to play a key role in the development of information-based medicine, particularly in psychiatry. Information technology will be ultimately able to combine various information sources including big data to present and enforce a holistic information-based approach to psychiatric care.


Author(s):  
Ken J. Farion ◽  
Michael J. Hine ◽  
Wojtek Michalowski ◽  
Szymon Wilk

Clinical decision-making is a complex process that is reliant on accurate and timely information. Clinicians are dependent (or should be dependent) on massive amounts of information and knowledge to make decisions that are in the best interest of the patient. Increasingly, information technology (IT) solutions are being used as a knowledge transfer mechanism to ensure that clinicians have access to appropriate knowledge sources to support and facilitate medical decision making. One particular class of IT that the medical community is showing increased interest in is clinical decision support systems (CDSSs).


2020 ◽  
pp. 167-186
Author(s):  
Steven Walczak

Clinical decision support systems are meant to improve the quality of decision-making in healthcare. Artificial intelligence is the science of creating intelligent systems that solve complex problems at the level of or better than human experts. Combining artificial intelligence methods into clinical decision support will enable the utilization of large quantities of data to produce relevant decision-making information to practitioners. This article examines various artificial intelligence methodologies and shows how they may be incorporated into clinical decision-making systems. A framework for describing artificial intelligence applications in clinical decision support systems is presented.


Cancers ◽  
2020 ◽  
Vol 12 (2) ◽  
pp. 369 ◽  
Author(s):  
Claudia Mazo ◽  
Cathriona Kearns ◽  
Catherine Mooney ◽  
William M. Gallagher

Breast cancer is the most frequently diagnosed cancer in women, with more than 2.1 million new diagnoses worldwide every year. Personalised treatment is critical to optimising outcomes for patients with breast cancer. A major advance in medical practice is the incorporation of Clinical Decision Support Systems (CDSSs) to assist and support healthcare staff in clinical decision-making, thus improving the quality of decisions and overall patient care whilst minimising costs. The usage and availability of CDSSs in breast cancer care in healthcare settings is increasing. However, there may be differences in how particular CDSSs are developed, the information they include, the decisions they recommend, and how they are used in practice. This systematic review examines various CDSSs to determine their availability, intended use, medical characteristics, and expected outputs concerning breast cancer therapeutic decisions, an area that is known to have varying degrees of subjectivity in clinical practice. Utilising the methodology of Kitchenham and Charter, a systematic search of the literature was performed in Springer, Science Direct, Google Scholar, PubMed, ACM, IEEE, and Scopus. An overview of CDSS which supports decision-making in breast cancer treatment is provided along with a critical appraisal of their benefits, limitations, and opportunities for improvement.


2017 ◽  
Vol 25 (3) ◽  
pp. 1091-1104 ◽  
Author(s):  
Mirza Mansoor Baig ◽  
Hamid GholamHosseini ◽  
Aasia A Moqeem ◽  
Farhaan Mirza ◽  
Maria Lindén

Supporting clinicians in decision making using advanced technologies has been an active research area in biomedical engineering during the past years. Among a wide range of ubiquitous systems, smartphone applications have been increasingly developed in healthcare settings to help clinicians as well as patients. Today, many smartphone applications, from basic data analysis to advanced patient monitoring, are available to clinicians and patients. Such applications are now increasingly integrating into healthcare for clinical decision support, and therefore, concerns around accuracy, stability, and dependency of these applications are rising. In addition, lack of attention to the clinicians’ acceptability, as well as the low impact on the medical professionals’ decision making, are posing more serious issues on the acceptability of smartphone applications. This article reviews smartphone-based decision support applications, focusing on hospital care settings and their overall impact of these applications on the wider clinical workflow. Additionally, key challenges and barriers of the current ubiquitous device-based healthcare applications are identified. Finally, this article addresses current challenges, future directions, and the adoption of mobile healthcare applications.


Author(s):  
Reza S. Kazemzadeh ◽  
Kamran Sartipi ◽  
Priya Jayaratna

Due to reliance on human knowledge, the practice of medicine is subject to errors that endanger patients’ health and cause substantial financial loss to healthcare institutions. Computer-based decision support systems assist healthcare personnel to improve quality of clinical practice. Currently, most clinical guideline modeling languages represent decision-making knowledge in terms of basic logical expressions. In this paper, we focus on encoding, sharing, and using results of data mining analyses to influence decision making within Clinical Decision Support Systems. A knowledge management framework is proposed that addresses the issues of data and knowledge interoperability by adopting healthcare and data mining modeling standards. In a further step, data mining results are incorporated into a guideline-based decision support system. A prototype tool has been developed to provide an environment for clinical guideline authoring and execution. Also, three real world case studies have been presented, one of which is used as a running example throughout the paper.


2015 ◽  
Vol 1 (1) ◽  
pp. 322-326
Author(s):  
Kerstin Denecke ◽  
Claire Chalopin

AbstractDisease development and progression are very complex processes which make clinical decision making non-trivial. On the one hand, examination results that are stored in multiple formats and data types in clinical information systems need to be considered. Beyond, biological or molecular-biological processes can influence clinical decision making. So far, biological knowledge and patient data is separated from each other. This complicates inclusion of all relevant knowledge and information into the decision making. In this paper, we describe a concept of model-based decision support that links knowledge about biological processes, treatment decisions and clinical data. It consists of three models: 1) a biological model, 2) a decision model encompassing medical knowledge about the treatment workflow and decision parameters, and 3) a patient data model generated from clinical data. Requirements and future steps for realizing the concept will be presented and it will be shown how the concept can support the clinical decision making.


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