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Widespread health service goals to improve consistency and safety in patient care have prompted considerable investment in the development of evidence-based clinical guidelines. Computerised decision support (CDS) systems have been proposed as a means to implement guidelines in practice. This paper discusses the general concept in oncology and presents an evaluation of a CDS system to support triple assessment (TA) in breast cancer care. Balanced-block crossover experiment and questionnaire study. One stop clinic for symptomatic breast patients. Twenty-four practising breast clinicians from United Kingdom National Health Service hospitals. A web-based CDS system. Clinicians made significantly more deviations from guideline recommendations without decision support (60 out of 120 errors without CDS; 16 out of 120 errors with CDS, P < 0.001). Ignoring minor deviations, 16 potentially critical errors arose in the no-decision-support arm of the trial compared with just one (P = 0.001) when decision support was available. Opinions of participating clinicians towards the CDS tool became more positive after they had used it (P < 0.025). The use of decision support capabilities in TA may yield significant measurable benefits for quality and safety of patient care. This is an important option for improving compliance with evidence-based practice guidelines.

Original publication

DOI

10.1038/sj.bjc.6603470

Type

Journal article

Journal

British Journal of Cancer

Publication Date

12/2006

Volume

95

Pages

1490 - 1496

Addresses

Advanced Computation Laboratory, Cancer Research UK, London WC2A 3PX, UK. vp@acl.icnet.uk

Keywords

Humans, Breast Neoplasms, Cross-Over Studies, Evidence-Based Medicine, Decision Making, Computer-Assisted, Female, Practice Guidelines as Topic