Distributed Decision Support Using a Web-based Interface

Although decision models can provide a formal foundation for guideline development and clinical decision support, their widespread use is often limited by the lack of plat form-independent software that geographically dispersed users can access and use easily without extensive training. To address these limitations the authors developed a World Wide Web-based interface for previously developed decision models. They describe the use and functionality of the interface using a decision model that evaluates the cost-effectiveness of strategies for preventing sudden cardiac death. The system allows an analyst to use a web browser to interact with the decision model and to change the values of input variables within pre-specified ranges, to specify sensitivity or threshold analyses, to evaluate the decision model, and to view the results gener ated dynamically. The web site also provides linkages to an explanation of the model, and evidence tables for input variables. The system demonstrates a method for pro viding distributed decision support to remote users such as guideline developers, de cision analysts, and potentially practicing physicians. The web interface provides plat form-independent and almost universal access to a decision model. This approach can make distributed decision support both practical and economical, and has the potential to increase the usefulness of decision models by enabling a broader audience to in corporate systematic analyses into both policy and clinical decisions. Key words: de cision-support techniques; practice guidelines; user-computer interface; decision anal ysis. (Med Decis Making 1999;19:157-166)