Who is afraid of the system? Doctors' attitude towards diagnostic systems

Although physicians indicate a need for diagnostic support, devices that may provide such support, i.e. computer-aided systems are not in widespread use. Practising physicians often blame this on the computer. We have tested this idea by asking physicians to solve a number of patient problems with the help of a diagnostic decision support system in a realistic environment. As we expected, the use of the computer was not found to be an obstacle. However, the support part of the system, which was meant to stimulate the user's thoughts and to prompt him to review his conclusions, turned out to be problematic. The critiquing function of the system hardly seemed appreciated by the participants, and only rarely influenced their diagnostic judgement. Sources of additional information were ignored. We have come to the conclusion that the combination of physicians and computer-aided diagnosis deserves further and thorough exploration.