Evidence-Based Decision Support for Neurological Diagnosis Reduces Errors and Unnecessary Workup (2014)

Author(s): Segal MM, Williams MS, Gropman AL, Torres AR, Forsyth R, Connolly AM, El-Hattab AW, Perlman SJ, Samanta D, Parikh S, Pavlakis SG, Feldman LK, Betensky RA, Gospe SM

    Abstract: Using vignettes of real cases and the SimulConsult diagnostic decision support software, neurologists listed differential diagnosis and workup before and after using the decision-support. Using the software, there was a significant reduction in error, up to 75% for diagnosis and 56% for workup. This error reduction occurred despite the baseline being one in which testers were allowed to use narrative resources and Web searching. A key factor that improved performance was taking enough time (> 2 minutes) to enter clinical findings into the software accurately. Under these conditions and for instances where the diagnoses changed based on using the software, diagnostic accuracy improved in 96% of instances. There was a 6% decrease in the number of workup items accompanied by a 34% increase in relevance. We conclude that decision support for neurological diagnosis can reduce error and save on unnecessary testing.

      • Date: 31-03-2014
      • Journal: Journal of Child Neurology
      • Volume: 29
      • Issue: 4
      • Pages: 487-492
      • Publisher: Sage Publications, Inc.
      • Publication type: Article
      • Bibliographic status: Published

      Dr Rob Forsyth
      Consultant/Senior Lecturer