Do physicians value decision support A look at the effect of decision support systems on physician opinion
Do physicians value decision support? A look at the effect of decision support systems on physician opinion.
Material and method
A web based system was set up, that would present the participants with 25 lesion images. These were chosen in a way that it would cover various levels of diagnostic difficulties and their correct diagnosis was already known. Further, a mock CDSS that would contradict physician’s diagnosis on purpose was set up. The study was conducted at Medical University of Vienna and 52 volunteer dermatologists with experience level novice to expert participated. The participants would rate the images on a scale of 0 to 10, where 0 = benign and 10 = malignant, and propose a dichotomous excise/no excise.
- Physician adopted CDSS suggestion 16.7%, when contradicted for dichotomous excise/no excise and 31.58% for ordinal malignancy rating.
- No difference was observed in physician changing their opinion to CDSS recommendation if it leads to “safe side” of diagnosis.
- A negative correlation was observed with the experience level of physician and tendency to adopt CDSS suggestion.
- The difference between physicians accepting CDSS recommendation when confident or not was highly significant.
There will be conflicts between physician opinion and CDSS recommendation as no CDSSs is 100% accurate. It was observed via the study that physician with less experience and when not confident about their diagnosis were more likely to accept CDSS recommendation. A physician is held accountable for incorrect diagnosis even if it was led by CDSS recommendation, thus further investigation is needed measure the worthiness of CDSS in routine clinical care.
Physicians are inclined to change their opinion based on CDSS suggestion.
CDSS should be a tool to help physician to make a correct diagnosis but as no CDSS is 100% accurate, the ability of this tool to do so is questionable in routine practice. Further, the liability is on the physician for any mistakes made even if aided by CDSS. As observed in this study, physicians are susceptible to accepting CDSS recommendation. A thorough investigation is needed before CDSS can be made a part of routine practice.
- Dreiseitl, S., & Binder, M. (2005). Do physicians value decision support? A look at the effect of decision support systems on physician opinion. Artificial intelligence in medicine, 33(1), 25-30.