Hostname: page-component-78c5997874-94fs2 Total loading time: 0 Render date: 2024-11-15T17:50:58.220Z Has data issue: false hasContentIssue false

Assessment and Diffusion of Computerized Decision Support Systems

Published online by Cambridge University Press:  10 March 2009

Robert R. Weaver
Affiliation:
Youngstown State University

Extract

This article discusses and identifies the weaknesses of approaches to assessing computerized decision support (CDS) systems, examining the design of two CDS systems, “DXplain” and the “Problem Knowledge Coupler” (PKC). It suggests that the inadequate assessment of CDS technologies will promote a conservative orientation toward their diffusion.

Type
General Essays
Copyright
Copyright © Cambridge University Press 1991

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1.Anderson, J. G., & Jay, S. J.Computers and clinical judgment: The role of physician networks. Social Science and Medicine, 1985, 20, 969–79.CrossRefGoogle ScholarPubMed
2.Barnett, G. O., Cimino, J.J., Hupp, J. A., & Hoffer, E. P.DXplain: An evolving diagnostic decision-support system. Journal of the American Medical Association, 1987, 258,67–74.CrossRefGoogle ScholarPubMed
3.Barnett, G. O., Cimino, J. J.Hupp, J. A., & Hoffer, E. P. DXplain: Experience with knowledge acquisition and program evaluation. Proceedings of the Eleventh Annual Symposium on Computer Applications in Medical Care, 1987, 150–54.Google Scholar
4.Buchanan, B. G., & Shortliffe, E. H. The problem of evaluation. In Buchanan, B. G., & Shortliffe, E. H. (eds.), Rule-based expert systems: The MYCIN experiments of the Stand-ford Heuristic Programming Project. Reading, MA: Addison-Wesley Publishing Company, 1984, 571–88.Google Scholar
5.Fineberg, H. V. Gastric freezing — A study of diffusion of a medical innovation. In the Committee on Technology and Health Care (ed.), Medical technology and the health care system: A study of the diffusion of equipment-embodied technology. Washington, DC: National Academy of Sciences, 1986, 173200.Google Scholar
6.Freidson, E.Profession of medicine: A study of the sociology of applied knowledge. New York: Harper & Row, Publishers, 1970.Google Scholar
7.Masarie, F. E. Jr., Miller, R. A., & Myers, J. D.INTERNIST-1 properties: Representing common sense and good medical practice in a computerized medical KB. Computers and Biomedical Research, 1985, 18, 458–79.CrossRefGoogle Scholar
8.Miller, R. A., Pople, H. E. Jr., & Myers, J. D.INTERNIST-1, an experimental computer-based diagnostic consultant for general internal medicine. New England Journal of Medicine, 1982, 307, 468–76.CrossRefGoogle ScholarPubMed
9.Singer, J., Sacks, H. S., Lucent, F., & Chalmers, T. C.Physician attitudes toward applications of computer database systems. Journal of the American Medical Association, 1983, 249, 1610–14.CrossRefGoogle Scholar
10.Stern, B. J.Social factors in medical progress. New York: AMS Press, 1927.CrossRefGoogle Scholar
11.Teach, R. L., & Shortliffe, E. H.An analysis of physicians' attitudes. Computers in Biomedical Research, 1981, 14, 542–58.CrossRefGoogle Scholar
12.Waitzkin, H. How capitalism cares for its coronaries: a preliminary exercise in political economy. In Gallagher, E. B. (ed.), The doctor-patient relationship in the changing health scene. DHEW Publication No.(NIH) Washington, DC: U. S. Government Printing Office, 1978, 78183.Google Scholar
13.Weed, L. L.Medical records, medical education, and patient care. Cleveland, OH: The Press of Case Western Reserve University, 1971.Google ScholarPubMed
14.Weed, L. L.The computer as a new basis for analytic clinical practice: Coupling individual problems with medical knowledge. The Mount Sinai Journal of Medicine, 1985, 52, 9498.Google ScholarPubMed
15.Weed, L. L.Knowledge coupling, medical education and patient care. CRC Critical Reviews in Medical Informatics, 1986, 1, 5579.Google ScholarPubMed
16.Weed, L. L.Flawed premises and educational malpractice: A view toward a more rational approach to medical practice. The Journal of Medical Practice Management, 1987, 2,239–54.Google Scholar
17.Weed, L. L. Medical education and patient care: Mistaken premises and inadequate tools, Physicians & Computers, 1987, 02, 3035.Google Scholar
18.Weed, L. L., Hertzberg, R. Y. The use and construction of Problem-knowledge Couplers, the Knowledge Coupler Editor, knowledge networks, and the Problem-oriented Medical Record for the microcomputer. Proceedings of the Seventh Annual Symposium on Computer Applications in Medical Care, 1983, 831–36.Google Scholar
19.Yu, V. L., Fagan, L. M., Bennett, S. W., et al. An evaluation of MYCIN's advice. In Buchanan, B. G. & Shortliffe, E. H. (eds.), Rule-based expert systems: The MYCIN experiments of the Standford Heuristic Programming Project. Reading, MA: Addison-Wesley Publishing Company, 1984, 589–96.Google Scholar