Design and implementation of a computer decision support system for the diagnosis and management of dementia syndromes in primary care.
BACKGROUND
Diagnosis and management of dementia is a complex process and primary care physicians are under-equipped to deal with uncertainties in the provision of optimal care for the patient.


OBJECTIVE
To develop a computer decision support system (CDSS) which could assist physicians with diagnosis and management and improve patient care.


METHODS
A design group including general practitioners derived logic pathways for diagnosis and management of dementia and validated them with a multiprofessional expert group. Logic pathways were used to construct a comprehensive CDSS rendered as a series of expert consultations. The CDSS was inserted into commercially available GP systems and bench and field-tested.


RESULTS
The complexity of dementia diagnosis and management can be captured in logic pathways which can be expressed as decision trees within existing electronic patient records. The resulting CDSS appears useable in routine practice.


CONCLUSIONS
The impact of this CDSS will be evaluated in a randomised controlled trial of educational interventions in primary care.
Iliffe
S
S
Department of Primary Care and Population Sciences, Royal Free and UCL Medical School, Royal Free Campus, Rowland Hill St., London NW3 2PF, England. s.iliffe@pcps.ucl.ac.uk
Austin
T
T
Wilcock
J
J
Bryans
M
M
Turner
S
S
Downs
M
M
D000368:Aged; D020000:Decision Support Systems, Clinical; D003663:Decision Trees; D003704:Dementia / Q000175:diagnosis* / Q000628:therapy*; D005103:Expert Systems; D005194:Family Practice; D006801:Humans; D006113:United Kingdom; D014584:User-Computer Interface