Effect of Written and Computerized Decision Support Aids for the U.S. Agency for Health Care Policy and Research Depression Guidelines on the Evaluation of Hypothetical Clinical Scenarios

Mitchell A. Medow, Timothy J. Wilt, Signe Dysken, Steve D. Hillson, Sharon Woods and Steven J. Borowsky
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Mitchell A. Medow: Ohio State University, Columbus, Ohio
Timothy J. Wilt: Minneapolis VA Medical Center, Minneapolis, Minnesota
Signe Dysken: Minneapolis VA Medical Center, Minneapolis, Minnesota
Steve D. Hillson: Hennepin County Medical Center, Minneapolis, Minnesota
Sharon Woods: Minneapolis VA Medical Center, Minneapolis, Minnesota
Steven J. Borowsky: Minneapolis VA Medical Center, Minneapolis, Minnesota

Medical Decision Making, 2001, vol. 21, issue 5, 344-356

Abstract: Objective. The objective of this study was to compare the effects of written and computerized decision support aids (DSAs) based on U.S. Agency for Health Care Policy and Research depression guidelines. Methods. Fifty-six internal medicine residents were randomized to evaluate clinical scenarios using either a written or a computerized DSA after first assessing scenarios without a DSA. The paired difference between aided and unaided scores was determined for diagnostic accuracy, treatment selection, severity and subtype classification, antipsychotic use, and mental health consultations. Results. Diagnostic accuracy with the written DSA increased from 64% to 73%, and with the computerized DSA decreased from 67% to 64% (P = 0.0065). Residents using the computerized DSA (vs. no DSA) requested fewer consultations (65% vs. 52% , P = 0.028). In post hoc analysis, the written DSA increased sensitivity (66% to 89% , P

Keywords: depression; practice guidelines; U.S. Agency for Health Care Policy and Research; guideline implementations; computer decision support aids (search for similar items in EconPapers)
Date: 2001
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Persistent link: https://EconPapers.repec.org/RePEc:sae:medema:v:21:y:2001:i:5:p:344-356

DOI: 10.1177/0272989X0102100501

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