Related Experiment Videos
Decision tools in health care: focus on the problem, not the solution
Joseph Liu1, Jeremy C Wyatt, Douglas G Altman
1Cancer Research UK/NHS Centre for Statistics in Medicine, Oxford University, UK. joe.liu@dphpc.ox.ac.uk
BMC Medical Informatics and Decision Making
|January 24, 2006
Summary
Many health technology innovations, like computerized decision support systems (DSS), fail in clinical practice. A new term, decision tool (DT), encompasses all aids, promoting cost-effective evaluation and clinical relevance over technology alone.
Area of Science:
- Health Informatics
- Clinical Decision Making
- Health Technology Assessment
Background:
- Systematic reviews and RCTs often insufficient for clinical adoption of health technologies.
- Numerous computerized decision support systems (DSS) have failed to integrate into routine clinical practice.
- A shift is needed from technology-driven development to cost-effective knowledge management in healthcare.
Purpose of the Study:
- To propose a generic term, 'decision tool' (DT), for various decision-making aids.
- To advocate for a unified approach to evaluating different types of decision aids.
- To encourage a focus on clinical relevance and cost-effectiveness in health technology development.
Main Methods:
- Conceptual analysis and synthesis of existing literature on health technology adoption.
- Definition and categorization of decision-making aids under the umbrella term 'decision tool'.
- Argument for a unified evaluation framework for all decision tools.
Main Results:
- Computerized DSSs frequently fail due to lack of clinical need, poor data quality, or technology-led development.
- Decision tools (DTs) are defined as active knowledge resources generating case-specific advice.
- DTs include computerized systems, paper algorithms, and mechanical aids, sharing conceptual similarities.
Conclusions:
- The term 'decision tool' (DT) unifies diverse decision-making aids, promoting shared learning.
- Evaluation methods for DTs should be consistent, regardless of their technical form.
- Focusing evaluation on clinical impact and cost-effectiveness will improve the adoption of useful health technologies.