Decision support in psychiatry
Bergman LG, Fors UG. Decision support in psychiatry - a comparison between the diagnostic outcomes using a computerized decision support system versus manual diagnosis. BMC Medical Informatics and Decision Making. 2008 Feb 8; 8:9.
Contents
Overview
Study out of Sweden in which the authors compared a paper and pencil diagnostic method (SCID1, Structured Clinical Interview for DSM IV-Axis I Disorders) with a computer-aided diagnostic system (CB-SCID1, Computer Based Structured Clinical Interview for DSM IV-Axis I Disorders.)
The authors cite studies showing there is conflicting evidence that Computerized Decision Support Systems may improve clinicians’ diagnostic ability in terms of accuracy of diagnosis and time to make a diagnosis. In doing their study the authors compared a relatively new CDSS system CB-SCID1 with a traditional non-computer based diagnostic system SCID1.
Methods
Outcome variables included time, correct diagnosis and incorrect diagnoses.
Two cases were selected form the DSM-IV Case Book. One was an easy case with one diagnosis and the other was a complex case with three diagnoses. There were 63 participants in the study who were all volunteers most of whom were either psychiatrists (30) or clinical psychologists (24). They were all given pre- and post-assessment surveys.
Results
Three main results were found:
- For the easy case there was no significant differences found between computer and paper and pencil diagnostic methods.
- Processing time for the difficult case was significantly shorter for the paper and pencil method than the computer based method.
- In the difficult case the correct diagnosis of ‘Depression’ was found more often in the paper and pencil method than in the computer based method.
Conclusion
The authors concluded
- There was no major difference in diagnostic outcome between the manual and computer based methods for psychiatric diagnosis.
- When there were significant differences the traditional method fared better.
- CDSS may affect diagnostic accuracy
