title: Clinical guideline representation in a CDS: a human information processing method.
abstract: The Dutch Childhood Oncology Group (DCOG) has developed evidence-based guidelines for screening childhood cancer survivors for possible late complications of treatment. These paper-based guidelines appeared to not suit clinicians' information retrieval strategies; it was thus decided to communicate the guidelines through a Computerized Decision Support (CDS) tool. To ensure high usability of this tool, an analysis of clinicians' cognitive strategies in retrieving information from the paper-based guidelines was used as requirements elicitation method. An information processing model was developed through an analysis of think aloud protocols and used as input for the design of the CDS user interface. Usability analysis of the user interface showed that the navigational structure of the CDS tool fitted well with the clinicians' mental strategies employed in deciding on survivors screening protocols. Clinicians were more efficient and more complete in deciding on patient-tailored screening procedures when supported by the CDS tool than by the paper-based guideline booklet. The think-aloud method provided detailed insight into users' clinical work patterns that supported the design of a highly usable CDS system.
authors.affiliation: Department of Medical Informatics, University of Amsterdam, The Netherlands. e.kilsdonk@amc.uva.nl
authors.forename: Ellen
authors.initials: E
authors.lastname: Kilsdonk
authors.forename: Rinke
authors.initials: R
authors.lastname: Riezebos
authors.forename: Leontien
authors.initials: L
authors.lastname: Kremer
authors.forename: Linda
authors.initials: L
authors.lastname: Peute
authors.forename: Monique
authors.initials: M
authors.lastname: Jaspers
mesh_terms: D002648:Child; D020000:Decision Support Systems, Clinical / Q000592:standards*; D019983:Guideline Adherence; D006801:Humans; D016347:Medical Records Systems, Computerized / Q000592:standards*; D009369:Neoplasms / Q000628:therapy*; D009426:Netherlands; D017410:Practice Guidelines as Topic; D010818:Practice Patterns, Physicians'; D014584:User-Computer Interface