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Evidence-Based Decision Support for Neurological Diagnosis Reduces Errors and Unnecessary Workup

Lookup NU author(s): Dr Rob Forsyth

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Abstract

Using vignettes of real cases and the SimulConsult diagnostic decision support software, neurologists listed differential diagnosis and workup before and after using the decision-support. Using the software, there was a significant reduction in error, up to 75% for diagnosis and 56% for workup. This error reduction occurred despite the baseline being one in which testers were allowed to use narrative resources and Web searching. A key factor that improved performance was taking enough time (> 2 minutes) to enter clinical findings into the software accurately. Under these conditions and for instances where the diagnoses changed based on using the software, diagnostic accuracy improved in 96% of instances. There was a 6% decrease in the number of workup items accompanied by a 34% increase in relevance. We conclude that decision support for neurological diagnosis can reduce error and save on unnecessary testing.


Publication metadata

Author(s): Segal MM, Williams MS, Gropman AL, Torres AR, Forsyth R, Connolly AM, El-Hattab AW, Perlman SJ, Samanta D, Parikh S, Pavlakis SG, Feldman LK, Betensky RA, Gospe SM

Publication type: Article

Publication status: Published

Journal: Journal of Child Neurology

Year: 2014

Volume: 29

Issue: 4

Pages: 487-492

Print publication date: 31/03/2014

ISSN (print): 0883-0738

ISSN (electronic): 1708-8283

Publisher: Sage Publications, Inc.

URL: http://dx.doi.org/10.1177/0883073813483365

DOI: 10.1177/0883073813483365


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