Imperial College London
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DrOlgaKostopoulou

Faculty of Medicine, Department of Surgery & Cancer

Reader in Medical Decision Making
 
 
 
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Contact

 

o.kostopoulou Website

 
 
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Location

 

5.07Medical SchoolSt Mary's Campus

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Summary

 

Publications

Citation

BibTex format

@article{Kostopoulou:2017:10.3399/bjgp16X688417,
author = {Kostopoulou, O and Porat, T and Corrigan, D and Mahmoud, S and Delaney, BC},
doi = {10.3399/bjgp16X688417},
journal = {British Journal of General Practice},
pages = {e201--e208},
title = {Diagnostic accuracy of GPs when using an early-intervention decision support system: a high-fidelity simulation},
url = {http://dx.doi.org/10.3399/bjgp16X688417},
volume = {67},
year = {2017}
}
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RIS format (EndNote, RefMan)

TY  - JOUR
AB  - Background Observational and experimental studies of the diagnostic task have demonstrated the importance of the first hypotheses that come to mind for accurate diagnosis. A prototype decision support system (DSS) designed to support GPs’ first impressions has been integrated with a commercial electronic health record (EHR) system.Aim To evaluate the prototype DSS in a high-fidelity simulation.Design and setting Within-participant design: 34 GPs consulted with six standardised patients (actors) using their usual EHR. On a different day, GPs used the EHR with the integrated DSS to consult with six other patients, matched for difficulty and counterbalanced.Method Entering the reason for encounter triggered the DSS, which provided a patient-specific list of potential diagnoses, and supported coding of symptoms during the consultation. At each consultation, GPs recorded their diagnosis and management. At the end, they completed a usability questionnaire. The actors completed a satisfaction questionnaire after each consultation.Results There was an 8–9% absolute improvement in diagnostic accuracy when the DSS was used. This improvement was significant (odds ratio [OR] 1.41, 95% confidence interval [CI] = 1.13 to 1.77, P<0.01). There was no associated increase of investigations ordered or consultation length. GPs coded significantly more data when using the DSS (mean 12.35 with the DSS versus 1.64 without), and were generally satisfied with its usability. Patient satisfaction ratings were the same for consultations with and without the DSS.Conclusion The DSS prototype was successfully employed in simulated consultations of high fidelity, with no measurable influences on patient satisfaction. The substantially increased data coding can operate as motivation for future DSS adoption.
AU  - Kostopoulou,O
AU  - Porat,T
AU  - Corrigan,D
AU  - Mahmoud,S
AU  - Delaney,BC
DO  - 10.3399/bjgp16X688417
EP  - 208
PY  - 2017///
SN  - 1478-5242
SP  - 201
TI  - Diagnostic accuracy of GPs when using an early-intervention decision support system: a high-fidelity simulation
T2  - British Journal of General Practice
UR  - http://dx.doi.org/10.3399/bjgp16X688417
UR  - https://bjgp.org/content/67/656/e201/
UR  - http://hdl.handle.net/10044/1/43811
VL  - 67
ER  -
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