Evaluating a mobile application for improving clinical laboratory test ordering and diagnosis.

Area of Science:

• Medical Informatics
• Clinical Decision Support
• Health Services Research

Background:

• Mobile applications for clinical decision support often lack rigorous evaluation.
• Effective diagnostic decision-making tools are crucial for improving patient care.

Purpose of the Study:

• To evaluate the impact of a mobile application, PTT Advisor, on generalist physicians' laboratory test ordering and diagnosis decisions.
• To assess physicians' perceptions of the app's utility as a learning tool.

Main Methods:

• An experimental vignette study involving 46 physicians across 7 US healthcare institutions.
• Physicians diagnosed 8 patient vignettes (normal PT, abnormal PTT) using either PTT Advisor or usual clinical decision support.
• Perceptions of usefulness were assessed using a modified Kirkpatrick Training Evaluation Framework.

Main Results:

• PTT Advisor use was associated with significantly higher diagnostic accuracy (82.6% vs 70.2%) and confidence (7.5 vs 6.3/10).
• Vignette completion time was reduced with PTT Advisor (3:02 vs 3:53 min).
• Physicians reported positive perceptions of the app's potential for improving clinical decision-making.

Conclusions:

• The PTT Advisor mobile application may enhance diagnostic accuracy and serve as a valuable learning tool for physicians.
• The study suggests similar evaluation methods can be applied to other diagnostic support applications.
• Improved diagnostic processes facilitated by mobile apps hold potential for better patient outcomes.