Berner Eta S, Maisiak Richard S, Heuderbert Gustavo R, Young K Randall
University of Alabama at Birmingham, AL, USA.
AMIA Annu Symp Proc. 2003;2003:76-80.
Clinical decision support systems (CDSS) can impact both diagnostic and therapeutic decision-making, but physicians sometimes fail to heed the appropriate CDSS advice, or become influenced in a negative way by the CDSS. This study examined the relationships among clinicians' prior diagnostic accuracy, the performance of a diagnostic CDSS, and how the CDSS influenced the accuracy of the clinician's subsequent diagnoses. Results showed that (1) clinicians who already were considering the correct diagnosis prior to using the CDSS were more likely to get the CDSS to produce the correct diagnosis in a prominent position than those not considering it initially; (2) physicians are strongly anchored by their initial diagnoses prior to using the CDSS; and (3) changes in the clinicians' diagnoses after using the CDSS are related to presence or absence of the correct diagnosis in the top 10 diagnoses displayed by the CDSS.
临床决策支持系统（CDSS）会对诊断和治疗决策产生影响，但医生有时会忽视CDSS给出的恰当建议，或者受到CDSS的负面影响。本研究考察了临床医生先前的诊断准确性、诊断性CDSS的性能，以及CDSS如何影响临床医生后续诊断的准确性之间的关系。结果表明：（1）在使用CDSS之前就已经在考虑正确诊断的临床医生，比最初未考虑正确诊断的临床医生更有可能让CDSS在显著位置给出正确诊断；（2）医生在使用CDSS之前会强烈依赖其初始诊断；（3）临床医生在使用CDSS后的诊断变化与CDSS显示的前10个诊断中是否存在正确诊断有关。
