Critiquing
Critiquing systems require that all the patient's clinical data, as well as the clinician's anticipated action be available in the computer. The critiquing system then generates a review of this decision based on its "understanding" of the patient's underlying patho-physiological condition and the risks associated with the planned therapeutic alternative chosen [Miller, 1983]. Such systems have met with their greatest success when incorporated into physician order entry systems. In such cases they can inform physicians of potential drug-drug, drug-lab, or drug-allergy interactions, as well as suggest less expensive alternatives. Given the diagnosis the physician is attempting to confirm or rule-out, a critiquing system might mention a more appropriate radiological exam [Harpole, 1997]. The management of a patient's hypertension [Miller, 1984] is another excellent example of a medical decision which begs for a critiquing system.
- Miller PL. Critiquing anesthetic management: the "ATTENDING" computer system. Anesthesiology. 1983 Apr;58(4):362-9.
- Miller PL, Black HR. Medical plan-analysis by computer: critiquing the pharmacologic management of essential hypertension. Comput Biomed Res. 1984 Feb;17(1):38-54.
- Harpole LH, Khorasani R, Fiskio J, Kuperman GJ, Bates DW. Automated evidence-based critiquing of orders for abdominal radiographs: impact on utilization and appropriateness. J Am Med Inform As# soc 1997 Nov-Dec;4(6):511-21
