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A conceptual framework for evaluating information technologies and decision support systems for bioterrorism
Dena M Bravata1, Kathryn M McDonald, Herbert Szeto
1Center for Primary Care and Outcomes Research, Stanford University, Stanford, California 94305-6019, USA. bravata@healthpolicy.stanford.edu
Summary
This study developed a framework to evaluate information technologies and decision support systems (IT/DSSs) for bioterrorism response. Findings show limited data on the accuracy of existing IT/DSSs for critical clinical and public health decisions.
Area of Science:
- Public Health
- Infectious Disease Epidemiology
- Health Informatics
Background:
- Bioterrorism preparedness requires effective decision-making by clinicians and public health officials.
- Existing information technologies and decision support systems (IT/DSSs) may aid in bioterrorism response.
- A systematic evaluation framework is needed to assess the utility of these IT/DSSs.
Purpose of the Study:
- To develop a conceptual framework for evaluating IT/DSSs for bioterrorism preparedness and response.
- To identify key decisions and information needs of clinicians and public health officials during a bioterrorism event.
- To establish criteria for assessing the performance of IT/DSSs in a bioterrorism context.
Main Methods:
- Literature review of infectious outbreaks and bioterrorism exercises.
- Expert consultation to identify critical decisions and information requirements.
- Task decomposition to define IT/DSS subtasks and data needs.
- Development and application of evaluation criteria to existing IT/DSSs.
Main Results:
- Identified 8 critical decision domains: 4 for clinicians (diagnosis, management, prevention, reporting) and 4 for public health officials (surveillance data interpretation, outbreak investigation, control, communication).
- Task decomposition revealed specific subtasks and data requirements for IT/DSSs.
- Evaluation of 217 IT/DSSs showed only 58 systems were assessed for performance metrics in 79 studies.
Conclusions:
- Clinicians and public health officials face 8 key decision types during bioterrorism response.
- The literature offers insufficient information regarding the accuracy and performance of available IT/DSSs for bioterrorism preparedness.
- Further research is needed to validate the effectiveness of IT/DSSs in real-world bioterrorism scenarios.