Evidence-based decision support for neurological diagnosis reduces errors and unnecessary workup.

Journal Article (Journal Article)

Using vignettes of real cases and the SimulConsult diagnostic decision support software, neurologists listed a 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 in which 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. The authors conclude that decision support for a neurological diagnosis can reduce errors and save on unnecessary testing.

Full Text

Duke Authors

Cited Authors

  • 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

Published Date

  • April 2014

Published In

Volume / Issue

  • 29 / 4

Start / End Page

  • 487 - 492

PubMed ID

  • 23576414

Electronic International Standard Serial Number (EISSN)

  • 1708-8283

Digital Object Identifier (DOI)

  • 10.1177/0883073813483365


  • eng

Conference Location

  • United States