Evaluating a mobile application for improving clinical laboratory test ordering and diagnosis

Mobile applications for improving diagnostic decision making often lack clinical evaluation. We evaluated if a mobile application improves generalist physicians' appropriate laboratory test ordering and diagnosis decisions and assessed if physicians perceive it as useful for learning. In an exp...

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Bibliographic Details
Published in:Journal of the American Medical Informatics Association : JAMIA 2018-07, Vol.25 (7), p.841-847
Main Authors: Meyer, Ashley N D, Thompson, Pamela J, Khanna, Arushi, Desai, Samir, Mathews, Benji K, Yousef, Elham, Kusnoor, Anita V, Singh, Hardeep
Format: Article
Language:English
Subjects:
Attitude of Health Personnel
Attitude to Computers
Clinical Decision-Making
Clinical Laboratory Techniques
Female
Humans
Internal Medicine
Male
Mobile Applications
Partial Thromboplastin Time
Physicians
Prothrombin Time
Research and Applications
United States
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Summary:Mobile applications for improving diagnostic decision making often lack clinical evaluation. We evaluated if a mobile application improves generalist physicians' appropriate laboratory test ordering and diagnosis decisions and assessed if physicians perceive it as useful for learning. In an experimental, vignette study, physicians diagnosed 8 patient vignettes with normal prothrombin times (PT) and abnormal partial thromboplastin times (PTT). Physicians made test ordering and diagnosis decisions for 4 vignettes using each resource: a mobile app, PTT Advisor, developed by the Centers for Disease Control and Prevention (CDC)'s Clinical Laboratory Integration into Healthcare Collaborative (CLIHC); and usual clinical decision support. Then, physicians answered questions regarding their perceptions of the app's usefulness for diagnostic decision making and learning using a modified Kirkpatrick Training Evaluation Framework. Data from 368 vignettes solved by 46 physicians at 7 US health care institutions show advantages for using PTT Advisor over usual clinical decision support on test ordering and diagnostic decision accuracy (82.6 vs 70.2% correct; P 
ISSN:1067-5027
1527-974X
DOI:10.1093/jamia/ocy026