Clinical decision support system recommendations: how often do radiologists and clinicians accept them?

Area of Science:

• Medical Informatics
• Radiology
• Clinical Decision Support

Background:

• Clinical decision support systems (CDSS) are increasingly used to aid medical professionals.
• Evaluating the reliability and acceptance of these tools is crucial for their effective implementation.
• The ESR iGuide is a CDSS tool designed to assist with imaging referral decisions.

Purpose of the Study:

• To assess the acceptance and reliability of the clinical decision support system (CDSS) imaging referral scores, known as ESR iGuide.
• To evaluate the agreement level of clinical experts with the recommendations provided by the ESR iGuide.

Main Methods:

• A pilot study was conducted in a tertiary hospital involving four experts rating 40 simulated clinical cases.
• Experts used a 5-level scale to assess agreement with ESR iGuide recommendations, noting reasons for disagreement.
• Descriptive statistics were calculated to determine the level of agreement among specialists.

Main Results:

• Experts showed a high average agreement rating of 4.17 ± 0.65 (median 4.25) on a 1-5 scale.
• Overall Percentage Agreement between the four experts was 77.28% in an optimistic scenario.
• Radiologists exhibited fewer disagreements with the CDSS tool compared to other physicians.

Conclusions:

• CDSS tools like ESR iGuide can effectively guide appropriate imaging examinations, potentially reducing costs from unnecessary scans.
• The study indicates good acceptance and reliability of the CDSS tool among clinical experts.
• Further large-scale, national-level research is recommended to validate these findings.