title: Accuracy of clinical data entry when using a computerized decision support system: a case study with OncoDoc2.
abstract: Some studies suggest that the implementation of health information technology (HIT) introduces unpredicted and unintended consequences including e-iatrogenesis. OncoDoc2 is a guideline-based clinical decision support system (CDSS) applied to the management of breast cancer. The system is used by answering closed-ended questions in order to document patient data while navigating through the knowledge base until the best patient-specific recommended treatments are obtained. OncoDoc2 has been used by three hospitals in real clinical settings and for genuine patients. We analysed 394 navigations, recorded on a 10-month period, which correspond to 6,025 data entries. The data entry error rate is 4.2%, spread over 52% of incorrect navigations (N-). However, the overall compliance rate of clinical decisions with guidelines significantly increased from 72.8% (without CDSS) to 87.3% (with CDSS). Although this increase is lowered because of N- navigations (compliance rates are respectively 95% and 80% for N+ and N- navigations), the benefits of HIT outweighted its disadvantages in our study.
authors.affiliation: UPMC, UFR de Médecine, Paris, France. brigitte.seroussi@tnn.aphp.fr
authors.forename: Brigitte
authors.initials: B
authors.lastname: Séroussi
authors.forename: Brigitte
authors.initials: B
authors.lastname: Blaszka-Jaulerry
authors.forename: Laurent
authors.initials: L
authors.lastname: Zelek
authors.forename: Jean-Pierre
authors.initials: JP
authors.lastname: Lefranc
authors.forename: Rosa
authors.initials: R
authors.lastname: Conforti
authors.forename: Jean-Philippe
authors.initials: JP
authors.lastname: Spano
authors.forename: Alexandra
authors.initials: A
authors.lastname: Rousseau
authors.forename: Jacques
authors.initials: J
authors.lastname: Bouaud
mesh_terms: D020000:Decision Support Systems, Clinical / Q000706:statistics & numerical data*; D057286:Electronic Health Records / Q000706:statistics & numerical data*; D005602:France; D055991:Health Records, Personal; D016247:Information Storage and Retrieval / Q000379:methods*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity