Reducing diagnostic errors in primary care
Computerized diagnostic decision support systems (CDDSS) Clinical Decision Support Systems (CDSS) for preventive management of COPD patients more frequently referred to as CDSS, provides assistance to practitioners and clinicians in the diagnosis and treatment process of patients. The basic assumption is that a CDDSS/CDSS can be utilized to reduced medical errors due to the rule sets that are present and their ability to compare and provide notice of a virtually endless number of adverse drug effects.
To provide an accurate review of the obstacles against or impeding the use of CDDSS within the primary health settings. Secondly, to measure the readiness of a CDDSS to meet the necessities of supporting the cognitive task of diagnosis.
The author decided to conduct a meta-review of existing systematic reviews specifically from the following: MEDLINE, Embase, PsycINFO and Web of Knowledge. The time frame of the articles are set after 2004. The articles reviewed are specific to the effectiveness of CDDSS for medical diagnosis. Specific criteria comprised of the systematic reviews where clinicians were principal end users of the CDDSS. The articles of interest specifically identified unique features of CDDSS specific to diagnostic performance.
The analysis included 1,970 studies which was a reduction of over 700 duplicates. Out of the 1,970, 1,938 of the articles were removed from the study due to the lack of incomplete systematic reviews or the documentation of minimum observations specific to diagnostics errors in a primary care. The pruning of the articles left 45 articles that met or exceeded the criteria. However, a repeat search was performed and located 2,696 articles. After the removal of duplicates the repeat search reduced to 1,983 records. After which 1,948 records were again excluded leaving 35 total articles for further review. And additional 23 articles were removed for the lack of containing observations on the impact of a CDDSS specific to diagnosis.
It is suggested that more literature is produced specifically in reference to CDDSS and medical diagnosis. The review provided four requirements that future CDDSS should possess. Which is a system able to utilize dynamic and evolving vocabulary, the ability to capture code relevant diagnostic findings, ability to suggest based on the best-available evidence. It is further suggested that the CDDSS is automatic and is linked to the EHR within the clinical setting. These items would make up a CDDSS with the ability to improve the current status of patient diagnosis. However, due to the lack of evidence and observations specific to the subject matter, more literature and observations will need to be conducted and published.