title: Evidence-based decision support for neurological diagnosis reduces errors and unnecessary workup.
abstract: Using vignettes of real cases and the SimulConsult diagnostic decision support software, neurologists listed a differential diagnosis and workup before and after using the decision support. Using the software, there was a significant reduction in error, up to 75% for diagnosis and 56% for workup. This error reduction occurred despite the baseline being one in which testers were allowed to use narrative resources and Web searching. A key factor that improved performance was taking enough time (>2 minutes) to enter clinical findings into the software accurately. Under these conditions and for instances in which the diagnoses changed based on using the software, diagnostic accuracy improved in 96% of instances. There was a 6% decrease in the number of workup items accompanied by a 34% increase in relevance. The authors conclude that decision support for a neurological diagnosis can reduce errors and save on unnecessary testing.
authors.affiliation: 1SimulConsult, Chestnut Hill, MA, USA.
authors.forename: Michael M
authors.initials: MM
authors.lastname: Segal
authors.forename: Marc S
authors.initials: MS
authors.lastname: Williams
authors.forename: Andrea L
authors.initials: AL
authors.lastname: Gropman
authors.forename: Alcy R
authors.initials: AR
authors.lastname: Torres
authors.forename: Rob
authors.initials: R
authors.lastname: Forsyth
authors.forename: Anne M
authors.initials: AM
authors.lastname: Connolly
authors.forename: Ayman W
authors.initials: AW
authors.lastname: El-Hattab
authors.forename: Seth J
authors.initials: SJ
authors.lastname: Perlman
authors.forename: Debopam
authors.initials: D
authors.lastname: Samanta
authors.forename: Sumit
authors.initials: S
authors.lastname: Parikh
authors.forename: Steven G
authors.initials: SG
authors.lastname: Pavlakis
authors.forename: Lynn K
authors.initials: LK
authors.lastname: Feldman
authors.forename: Rebecca A
authors.initials: RA
authors.lastname: Betensky
authors.forename: Sidney M
authors.initials: SM
authors.lastname: Gospe
mesh_terms: D003658:Decision Making, Computer-Assisted; D003937:Diagnosis, Differential; D003951:Diagnostic Errors / Q000517:prevention & control* / Q000706:statistics & numerical data; D019317:Evidence-Based Medicine; D005260:Female; D006801:Humans; D020407:Internet; D008297:Male; D009422:Nervous System Diseases / Q000175:diagnosis*; D012984:Software
keywords: decision support; diagnosis; errors; genetics; medical informatics; neurogenetics