CREDO Phase 1: Can computer aided decision support help doctors choose the correct management path for patients undergoing triple assessment for possible breast cancer ?
Sharon Love with Vivek Patkar, John Fox and Chris Hurt (London)Modern clinical practice has been described as “a humanly impossible task”. As the knowledge base of medicine continues to grow the demands on those who are required to deliver consistent, high quality, safe and accountable care is effectively impossible to satisfy unaided. Among the most promising new developments that may help to address this challenge and reduce the burdens on clinical and other healthcare professionals are “point of care” information and decision support systems.
CREDO is intended to demonstrate that modern computer technology can significantly improve the effectiveness of cancer service delivery and we have chosen triple assessment (TA) or “same day assessment” as the focus of our first trial.
In triple assessment a woman is diagnosed as having or not having breast cancer. TA has a tremendous impact on the life of the woman, whatever the outcome. TA also embodies complexities which will occur at many points in an integrated multidisciplinary care process, in that it entails a number of interrelated decisions and coordination of multiple disciplines based on the outcomes.
In the first phase 24 clinicians have each done a triple assessment on 10 paper patients using the computer decision support system for 5 and without such support for the other 5.
The analysis has compared errors made when using or not using decision support. The analysis is currently at the publication preparation stage.
