Implications for the design of a Diagnostic Decision Support System (DDSS) to reduce time and cost to diagnosis in paediatric shoulder instability

Faux-Nightingale, Alice; De Quincey, Edward

Abstract

<jats:title>Abstract</jats:title><jats:sec> <jats:title>Background</jats:title> <jats:p>Currently the diagnosis of shoulder instability, particularly in children, is difficult and can take time. These diagnostic delays can lead to poorer outcome and long-term complications. A Diagnostic Decision Support System (DDSS) has the potential to reduce time to diagnosis and improve outcomes for patients. The aim of this study was to develop a concept map for a future DDSS in shoulder instability.</jats:p> </jats:sec><jats:sec> <jats:title>Methods</jats:title> <jats:p>A modified nominal focus group technique, involving three clinical vignettes, was used to elicit physiotherapists decision-making processes.</jats:p> </jats:sec><jats:sec> <jats:title>Results</jats:title> <jats:p>Twenty-five physiotherapists, (18F:7 M) from four separate clinical sites participated. The themes identified related to ‘Variability in diagnostic processes and lack of standardised practice’ and ‘Knowledge and attitudes towards novel technologies for facilitating assessment and clinical decision making’.</jats:p> </jats:sec><jats:sec> <jats:title>Conclusion</jats:title> <jats:p>No common structured approach towards assessment and diagnosis was identified. Lack of knowledge, perceived usefulness, access and cost were identified as barriers to adoption of new technology. Based on the information elicited a conceptual design of a future DDSS has been proposed. Work to develop a systematic approach to assessment, classification and diagnosis is now proposed.</jats:p> <jats:p><jats:italic>Trial Registraty</jats:italic> This was not a clinical trial and so no clinical trial registry is needed.</jats:p> </jats:sec>

Citation

Faux-Nightingale, A., De Quincey, E., Philp, F., Woolley, S., Pandyan, A., & de Quincey, E. (in press). Implications for the design of a Diagnostic Decision Support System (DDSS) to reduce time and cost to diagnosis in paediatric shoulder instability. BMC Medical Informatics and Decision Making, 21(1), Article ARTN 78. https://doi.org/10.1186/s12911-021-01446-5

• Journal Article Type: Article
• Acceptance Date: Feb 16, 2021
• Online Publication Date: Feb 27, 2021
• Publicly Available Date: May 30, 2023
• Journal: BMC Medical Informatics and Decision Making
• Electronic ISSN: 1472-6947
• Publisher: Springer Verlag
• Peer Reviewed: Peer Reviewed
• Volume: 21
• Issue: 1
• Article Number: ARTN 78
• DOI: https://doi.org/10.1186/s12911-021-01446-5
• Keywords: Physiotherapy; Shoulder instability; User centred design; Clinical decision support system; Paediatrics
• Publisher URL: https://bmcmedinformdecismak.biomedcentral.com/articles/10.1186/s12911-021-01446-5