title: Description and pilot evaluation of the Metabolic Irregularities Narrowing down Device software: a case analysis of physician programming.
abstract: BACKGROUND
  There is a gap between the abilities and the everyday applications of Computerized Decision Support Systems (CDSSs). This gap is further exacerbated by the different 'worlds' between the software designers and the clinician end-users. Software programmers often lack clinical experience whereas practicing physicians lack skills in design and engineering.
  
  
  OBJECTIVE
  Our primary objective was to evaluate the performance of Metabolic Irregularities Narrowing down Device (MIND) intelligent medical calculator and differential diagnosis software through end-user surveys and discuss the roles of CDSS in the inpatient setting.
  
  
  METHODS
  A tertiary care, teaching community hospital.
  
  
  METHODS
  Thirty-one responders answered the survey. Responders consisted of medical students, 24%; attending physicians, 16%, and residents, 60%.
  
  
  RESULTS
  About 62.5% of the responders reported that MIND has the ability to potentially improve the quality of care, 20.8% were sure that MIND improves the quality of care, and only 4.2% of the responders felt that it does not improve the quality of care. Ninety-six percent of the responders felt that MIND definitely serves or has the potential to serve as a useful tool for medical students, and only 4% of the responders felt otherwise. Thirty-five percent of the responders rated the differential diagnosis list as excellent, 56% as good, 4% as fair, and 4% as poor.
  
  
  CONCLUSIONS
  MIND is a suggesting, interpreting, alerting, and diagnosing CDSS with good performance and end-user satisfaction. In the era of the electronic medical record, the ongoing development of efficient CDSS platforms should be carefully considered by practicing physicians and institutions.
authors: Internal Medicine Residency Program, Sinai Hospital of Baltimore, Baltimore, MD, USA.|Division of Pulmonary and Critical Care, Virginia Commonwealth University, Richmond, VA, USA; mkashiouris@vcu.edu.
authors: Markos G
authors: MG
authors: Kashiouris
authors: Internal Medicine Residency Program, Sinai Hospital of Baltimore, Baltimore, MD, USA.|Division of Medical Oncology, National Institutes of Health, Bethesda, MD, USA.
authors: Miloš
authors: M
authors: Miljković
authors: Division of Anesthesiology, Mayo Clinic College of Medicine, Rochester, MN, USA.
authors: Vitaly
authors: V
authors: Herasevich
authors: Division of Emergency Medicine, Oregon Health & Sciences University, Portland, OR, USA.
authors: Andrew D
authors: AD
authors: Goldberg
authors: Internal Medicine Residency Program, Sinai Hospital of Baltimore, Baltimore, MD, USA.
authors: Charles
authors: C
authors: Albrecht
keywords: computerized decision support systems; differential diagnosis software; medical calculator
references: J Biomed Inform. 2006 Dec;39(6):656-67
references: 16442854
references: J Am Med Inform Assoc. 2007 Jul-Aug;14(4):489-96
references: 17460131
references: Crit Pathw Cardiol. 2007 Sep;6(3):121-6
references: 17804972
references: J Epidemiol Community Health. 1998 Aug;52(8):520-5
references: 9876364
references: Arch Intern Med. 2005 Nov 14;165(20):2388-94
references: 16287768
references: Proc AMIA Symp. 2000;:146-50
references: 11079862
references: Evid Based Med. 2006 Dec;11(6):162-4
references: 17213159
references: Chest. 2000 Aug;118(2 Suppl):8S-17S
references: 10939994
references: Proc AMIA Annu Fall Symp. 1997;:228-32
references: 9357622
references: N Engl J Med. 1998 Jan 22;338(4):259-60
references: 9435335
references: Br J Anaesth. 2007 Jan;98(1):60-5
references: 17065170
references: JAMA. 2005 Mar 9;293(10):1223-38
references: 15755945
references: J Am Med Inform Assoc. 2003 Nov-Dec;10(6):523-30
references: 12925543
references: Crit Care Med. 2005 Jan;33(1):110-4
references: 15644656
references: J Healthc Inf Manag. 2002 Fall;16(4):2-4
references: 12365292
references: JAMA. 1999 Nov 17;282(19):1851-6
references: 10573277
references: AMIA Annu Symp Proc. 2003;:76-80
references: 14728137
references: Int J Technol Assess Health Care. 2000 Winter;16(1):210-27
references: 10815366
references: Outcomes Manag Nurs Pract. 1999 Jul-Sep;3(3):118-27
references: 10603885
references: AMIA Annu Symp Proc. 2003;:862
references: 14728367
references: Anesth Analg. 2006 Feb;102(2):530-2
references: 16428555
references: Pharm World Sci. 2007 Aug;29(4):342-9
references: 17458707
references: JAMA. 2000 Jun 7;283(21):2816-21
references: 10838650
references: BMJ. 2005 Apr 2;330(7494):740-1
references: 15802700
references: Med Educ. 2004 Jun;38(6):628-37
references: 15189259