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Use and acceptability of an asthma diagnosis clinical decision support system for primary care clinicians: an
Luke Daines1, Anne Canny2, Eddie Donaghy2
1Asthma UK Centre for Applied Research, Usher Institute, University of Edinburgh, Edinburgh, UK. luke.daines@ed.ac.uk.
Insights
A new clinical decision support system (CDSS) for asthma diagnosis in young people was feasible and acceptable in UK primary care. Clinicians found the asthma diagnostic tool easy to use, though its impact on experienced practitioners was questioned.
Area of Science:
- Primary Care Medicine
- Clinical Decision Support Systems
- Pediatric Respiratory Health
Background:
- Asthma diagnosis in primary care is challenging, leading to frequent misdiagnoses.
- Accurate asthma diagnosis is crucial for effective management in children and young people.
- A need exists for improved diagnostic tools in primary care settings.
Purpose of the Study:
- To evaluate the feasibility and acceptability of a novel clinical decision support system (CDSS) for asthma diagnosis.
- To assess the usability and integration of the CDSS in routine UK primary care consultations.
- To gather clinician feedback on the potential benefits and limitations of the CDSS.
Main Methods:
- A prospective study involving general practices in England and Scotland.
- Deployment of the CDSS during routine consultations for a six-month period.
- Quantitative analysis of CDSS usage data and qualitative interviews with participating clinicians.
Main Results:
- The CDSS was utilized by 75 out of 94 clinicians across 10 participating practices.
- Clinicians reported the CDSS as easy to use, appreciating its auto-population feature.
- Barriers included limited direct note integration and perceived limited utility for experienced clinicians.
Conclusions:
- The asthma diagnostic CDSS is a feasible and acceptable tool for UK primary care.
- The system shows promise, particularly for supporting trainees and less experienced clinicians.
- Further development may be needed to address integration barriers and perceived value for all user levels.
Abstract:
There is uncertainty about how best to diagnose asthma, especially in primary care where mis-diagnosis is common. To address this, we developed a clinical decision support system (CDSS) for asthma diagnosis in children and young people (aged 5-25 years). This study explored the feasibility and acceptability of the CDSS in UK primary care. We recruited general practices from England and Scotland. The CDSS was available for use during routine consultations for six months. We analysed CDSS usage and, toward the end of the study, undertook qualitative interviews with clinicians who had used the CDSS. Within the 10 practices who completed the study, the CDSS was used by 75 out of 94 clinicians. 11 clinicians from 8 practices were interviewed. The CDSS was acceptable to participants who particularly commented on the ease of use and auto-population of information from the patient record. Barriers to use included the inability to record findings directly into the patient notes and a sense that, whilst possibly useful for trainees and junior colleagues, the CDSS would not necessarily lead to a change in their own practice. The CDSS was generally well received by primary care clinicians, though participants felt it would be most useful for trainees and less experienced colleagues.
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