Decision Support in the Context of a Complex Decision Situation
This addresses the problem of poorly implemented decision support tools for physicians, but it is incremental as it builds on existing critiques without introducing new methods or data.
The paper argues that clinical decision support tools can confuse physicians and complicate care when they provide information without clinical context, and suggests that future challenges involve optimizing both predictive models and effective communication of context to doctors.
The aim of a clinical decision support tool is to reduce the complexity of clinical decisions. However, when decision support tools are poorly implemented they may actually confuse physicians and complicate clinical care. This paper argues that information from decision support tools is often removed from the clinical context of the targeted decisions. Physicians largely depend on clinical context to handle the complexity of their day-to-day decisions. Clinical context enables them to take into account all ambiguous information and patient preferences. Decision support tools that provide analytic information to physicians, without its context, may then complicate the decision process of physicians. It is likely that the joint forces of physicians and technology will produce better decisions than either of them exclusively: after all, they do have different ways of dealing with the complexity of a decision and are thus complementary. Therefore, the future challenges of decision support do not only reside in the optimization of the predictive value of the underlying models and algorithms, but equally in the effective communication of information and its context to doctors.