The evaluation of expert diagnostic systems. How to assess outcomes and quality parameters?

Improvement of the quality in health care and the assessment of health outcomes of medical technologies have attracted an increasing attention in the implementation phases. In this paper 10 recent evaluation studies are reviewed to investigate to what extent they reflect the structure, process, and outcome of the conceptual framework. It is found that all the evaluation studies focus on structure measures. But if computer programs to support medical decision making are to be considered in the planning process of the health care system, the evaluation studies must strive to evaluate process and outcomes measures as well. A proposal for a framework for this kind of exploratory and evaluative research is outlined.