Barriers to the Use of Clinical Decision Support for the Evaluation of Pulmonary Embolism: Qualitative Interview Study

BackgroundClinicians often disregard potentially beneficial clinical decision support (CDS). ObjectiveIn this study, we sought to explore the psychological and behavioral barriers to the use of a CDS tool. MethodsWe conducted a qualitative study involv...

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Главные авторы: Safiya Richardson, Katherine L Dauber-Decker, Thomas McGinn, Douglas P Barnaby, Adithya Cattamanchi, Renee Pekmezaris
Формат: Статья
Язык:English
Опубликовано: JMIR Publications 2021-08-01
Серии:JMIR Human Factors
Online-ссылка:https://humanfactors.jmir.org/2021/3/e25046
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author Safiya Richardson
Katherine L Dauber-Decker
Thomas McGinn
Douglas P Barnaby
Adithya Cattamanchi
Renee Pekmezaris
author_facet Safiya Richardson
Katherine L Dauber-Decker
Thomas McGinn
Douglas P Barnaby
Adithya Cattamanchi
Renee Pekmezaris
author_sort Safiya Richardson
collection DOAJ
description BackgroundClinicians often disregard potentially beneficial clinical decision support (CDS). ObjectiveIn this study, we sought to explore the psychological and behavioral barriers to the use of a CDS tool. MethodsWe conducted a qualitative study involving emergency medicine physicians and physician assistants. A semistructured interview guide was created based on the Capability, Opportunity, and Motivation-Behavior model. Interviews focused on the barriers to the use of a CDS tool built based on Wells’ criteria for pulmonary embolism to assist clinicians in establishing pretest probability of pulmonary embolism before imaging. ResultsInterviews were conducted with 12 clinicians. Six barriers were identified, including (1) Bayesian reasoning, (2) fear of missing a pulmonary embolism, (3) time pressure or cognitive load, (4) gestalt includes Wells’ criteria, (5) missed risk factors, and (6) social pressure. ConclusionsClinicians highlighted several important psychological and behavioral barriers to CDS use. Addressing these barriers will be paramount in developing CDS that can meet its potential to transform clinical care.
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spelling doaj.art-fd23f5a1ca3d42699e7a6f788aad0e052023-08-28T18:27:56ZengJMIR PublicationsJMIR Human Factors2292-94952021-08-0183e2504610.2196/25046Barriers to the Use of Clinical Decision Support for the Evaluation of Pulmonary Embolism: Qualitative Interview StudySafiya Richardsonhttps://orcid.org/0000-0002-8576-1102Katherine L Dauber-Deckerhttps://orcid.org/0000-0002-0498-8779Thomas McGinnhttps://orcid.org/0000-0003-1005-227XDouglas P Barnabyhttps://orcid.org/0000-0002-2135-0224Adithya Cattamanchihttps://orcid.org/0000-0002-6553-2601Renee Pekmezarishttps://orcid.org/0000-0003-2731-6489 BackgroundClinicians often disregard potentially beneficial clinical decision support (CDS). ObjectiveIn this study, we sought to explore the psychological and behavioral barriers to the use of a CDS tool. MethodsWe conducted a qualitative study involving emergency medicine physicians and physician assistants. A semistructured interview guide was created based on the Capability, Opportunity, and Motivation-Behavior model. Interviews focused on the barriers to the use of a CDS tool built based on Wells’ criteria for pulmonary embolism to assist clinicians in establishing pretest probability of pulmonary embolism before imaging. ResultsInterviews were conducted with 12 clinicians. Six barriers were identified, including (1) Bayesian reasoning, (2) fear of missing a pulmonary embolism, (3) time pressure or cognitive load, (4) gestalt includes Wells’ criteria, (5) missed risk factors, and (6) social pressure. ConclusionsClinicians highlighted several important psychological and behavioral barriers to CDS use. Addressing these barriers will be paramount in developing CDS that can meet its potential to transform clinical care.https://humanfactors.jmir.org/2021/3/e25046
spellingShingle Safiya Richardson
Katherine L Dauber-Decker
Thomas McGinn
Douglas P Barnaby
Adithya Cattamanchi
Renee Pekmezaris
Barriers to the Use of Clinical Decision Support for the Evaluation of Pulmonary Embolism: Qualitative Interview Study
JMIR Human Factors
title Barriers to the Use of Clinical Decision Support for the Evaluation of Pulmonary Embolism: Qualitative Interview Study
title_full Barriers to the Use of Clinical Decision Support for the Evaluation of Pulmonary Embolism: Qualitative Interview Study
title_fullStr Barriers to the Use of Clinical Decision Support for the Evaluation of Pulmonary Embolism: Qualitative Interview Study
title_full_unstemmed Barriers to the Use of Clinical Decision Support for the Evaluation of Pulmonary Embolism: Qualitative Interview Study
title_short Barriers to the Use of Clinical Decision Support for the Evaluation of Pulmonary Embolism: Qualitative Interview Study
title_sort barriers to the use of clinical decision support for the evaluation of pulmonary embolism qualitative interview study
url https://humanfactors.jmir.org/2021/3/e25046
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