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Effect of Written and Computerized Decision Support Aids for the U.S. Agency for Health Care Policy and Research Depression Guidelines on the Evaluation of Hypothetical Clinical Scenarios

Author

Listed:
  • Mitchell A. Medow

    (Ohio State University, Columbus, Ohio)

  • Timothy J. Wilt

    (Minneapolis VA Medical Center, Minneapolis, Minnesota)

  • Signe Dysken

    (Minneapolis VA Medical Center, Minneapolis, Minnesota)

  • Steve D. Hillson

    (Hennepin County Medical Center, Minneapolis, Minnesota)

  • Sharon Woods

    (Minneapolis VA Medical Center, Minneapolis, Minnesota)

  • Steven J. Borowsky

    (Minneapolis VA Medical Center, Minneapolis, Minnesota)

Abstract

Objective. The objective of this study was to compare the effects of written and computerized decision support aids (DSAs) based on U.S. Agency for Health Care Policy and Research depression guidelines. Methods. Fifty-six internal medicine residents were randomized to evaluate clinical scenarios using either a written or a computerized DSA after first assessing scenarios without a DSA. The paired difference between aided and unaided scores was determined for diagnostic accuracy, treatment selection, severity and subtype classification, antipsychotic use, and mental health consultations. Results. Diagnostic accuracy with the written DSA increased from 64% to 73%, and with the computerized DSA decreased from 67% to 64% (P = 0.0065). Residents using the computerized DSA (vs. no DSA) requested fewer consultations (65% vs. 52% , P = 0.028). In post hoc analysis, the written DSA increased sensitivity (66% to 89% , P

Suggested Citation

  • Mitchell A. Medow & Timothy J. Wilt & Signe Dysken & Steve D. Hillson & Sharon Woods & Steven J. Borowsky, 2001. "Effect of Written and Computerized Decision Support Aids for the U.S. Agency for Health Care Policy and Research Depression Guidelines on the Evaluation of Hypothetical Clinical Scenarios," Medical Decision Making, , vol. 21(5), pages 344-356, October.
    • Handle: RePEc:sae:medema:v:21:y:2001:i:5:p:344-356
    DOI: 10.1177/0272989X0102100501
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