Table 1 Assessment of a variety of aids to clinical decisions by decision tool criteria
From: Decision tools in health care: focus on the problem, not the solution
Characteristics of decision tools | ||||
|---|---|---|---|---|
Tool | User Designed to aid clinical decisions by health professional or patient? | Target decision Decisions about a real individual patient? | Knowledge component Does tool use knowledge to assist interpretation or aid clinical decision making | Timing Is tool used before health professional or patient makes the relevant decision? |
1. Computerized reminder system for preventive care (e.g. Dexter et al [12]) | Yes | Yes | Yes | Yes |
2. Paper reminder to check for sign X, take into account symptom Y or take action Z when seeing a patient (e.g. Bryce et al [26] and Eccles et al [11]) | Yes | Yes | Yes | Yes |
3. Care pathway (e.g. Holtzman et al [27]) | Yes | Yes | Yes | Yes |
4. Tool to enhance shared decision making [28] | Yes | Yes | Yes | Yes |
5. Computerised patient interviewing (checklist for patient to complete, after which the data are presented to the doctor in summary form (e.g. Lilford et al [29]) | Yes | Yes | Yes | Yes |
6. Sheet for doctor giving definitions of clinical findings in acute abdominal pain or advice on how to elicit them | Yes | Yes | Yes | Yes |
7. Nomograms | Yes | Yes | Yes | Yes |
8. Joint British Societies coronary risk prediction charts [2] | Yes | Yes | Yes | Yes |
9. Telemedicine system [30] | Yes | Yes | Yes | Yes |
10. Information leaflet for patient with acute abdominal pain | Yes | Yes | Yes | Yes |
11. Sheet summarising results of special investigations with advice on interpreting results | Yes | Yes | Yes | Yes |
12. Distance learning material used away from patients (e.g. in a course, or self-study) (see examples in Davis et al [31]) | Yes | No | Yes | No |
13. Monthly performance feedback report (i.e. giving doctors feedback about their performance on previous groups of patients) | Yes | No | No | Yes |
14. Computer simulator to help doctors develop their diagnostic skills (e.g. Hoffer & Barnett [32]) | Yes | No | Yes | Yes |
15. Imaging investigation, e.g. ultrasonography, computed tomography | Yes | Yes | No | Yes |
16. Laboratory test, e.g. white cell count, C-reactive protein | Yes | Yes | No | Yes |
17. Audit on clinical activities in a GP surgery | No | No | No | No |