While many healthcare professionals champion the benefits of using digital diagnostic tools to help decide on medical treatment, patients show a tendency to be dissatisfied with such aids.
Computerised clinical decision support systems (CDSSs) used by doctors are viewed with disfavour by many patients. This is the finding of a study* carried out by a group of researchers led by Victoria A. Shaffer, Assistant Professor of Health Sciences and Psychological Sciences at the University of Missouri, USA. In one of several experiments carried out by her team, students assuming the role of a patient with a possible ankle fracture were asked to read various scenarios describing a consultation with a doctor. One scenario featured a doctor who used no decision support systems, another described one who used an unspecified DSS, while a third used a DSS developed at a prestigious medical centre. The student ‘patients’ were then asked to rate, among other criteria, the doctor’s diagnostic ability. The research team found that, in the main, the experiment participants took a dim view of the doctor using DSS.
Dissatisfaction with DSS-dependent doctors
How the experiment worked was that the student ‘patients’ were asked to mark on a scale of 1 to 7 (7 being the most favourable) the doctor’s diagnostic ability, professionalism, accuracy, and the patient’s general satisfaction with the doctor. On this last point, 18% of those asked to follow a scenario where the doctor made use of DSS gave a mark of 1 or 2 out of 7, while only 8% of the patients diagnosed without any use of DSS marked so low. All the criteria showed the same trend. Doctors using DSS were given a mark of 1 by 3% of the patients but no doctor who made a diagnosis unaided by DSS received a 1. However it is interesting to note that 16% of the participants gave a 7 to the DSS-using doctors, compared with just 12% who rated the non-DSS-using medics so highly.
In control or dependent on destiny?
From these latter figures, which went somewhat against the grain of the other findings of the study, the researchers deduced that not all the experiment participants had an identical opinion of DSS use in the healthcare sector. They therefore tried to analyse what personality traits would make a person more or less likely to trust a doctor using these digital tools. What emerged in particular was the way different people perceive life’s events. The researchers found that the majority of those who believe they are in control of their own destiny think less highly of a doctor who uses DSS than those who assume that the course of events is outside their control.
*“Why Do Patients Derogate Physicians Who Use a Computer-Based Diagnostic Support System?” – published in the journal Medical Decision Making.