title: Distributed decision support using a web-based interface: prevention of sudden cardiac death.
abstract: Although decision models can provide a formal foundation for guideline development and clinical decision support, their widespread use is often limited by the lack of platform-independent software that geographically dispersed users can access and use easily without extensive training. To address these limitations the authors developed a World Wide Web-based interface for previously developed decision models. They describe the use and functionality of the interface using a decision model that evaluates the cost-effectiveness of strategies for preventing sudden cardiac death. The system allows an analyst to use a web browser to interact with the decision model and to change the values of input variables within pre-specified ranges, to specify sensitivity or threshold analyses, to evaluate the decision model, and to view the results generated dynamically. The web site also provides linkages to an explanation of the model, and evidence tables for input variables. The system demonstrates a method for providing distributed decision support to remote users such as guideline developers, decision analysts, and potentially practicing physicians. The web interface provides platform-independent and almost universal access to a decision model. This approach can make distributed decision support both practical and economical, and has the potential to increase the usefulness of decision models by enabling a broader audience to incorporate systematic analyses into both policy and clinical decisions.
authors.affiliation: Center for Primary Care and Outcomes Research, Department of Medicine, Stanford University, California 94305-5405, USA. sanders@smi.stanford.edu
authors.forename: G D
authors.initials: GD
authors.lastname: Sanders
authors.forename: C G
authors.initials: CG
authors.lastname: Hagerty
authors.forename: F A
authors.initials: FA
authors.lastname: Sonnenberg
authors.forename: M A
authors.initials: MA
authors.lastname: Hlatky
authors.forename: D K
authors.initials: DK
authors.lastname: Owens
mesh_terms: D000889:Anti-Arrhythmia Agents / Q000191:economics / Q000627:therapeutic use; D001145:Arrhythmias, Cardiac / Q000150:complications* / Q000628:therapy*; D003362:Cost-Benefit Analysis; D016757:Death, Sudden, Cardiac / Q000209:etiology* / Q000517:prevention & control*; D003663:Decision Trees; D017147:Defibrillators, Implantable / Q000191:economics; D006801:Humans; D020407:Internet / Q000458:organization & administration*; D008390:Markov Chains; D017410:Practice Guidelines as Topic; D012680:Sensitivity and Specificity; D016896:Treatment Outcome; D014584:User-Computer Interface
chemical_list: D000889:Anti-Arrhythmia Agents