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

Details

• Alternative Title:
  J Am Med Inform Assoc
• Personal Author:
  Meyer, Ashley ND ; Thompson, Pamela J ; Khanna, Arushi ; Desai, Samir ; Mathews, Benji K ; Yousef, Elham ; Kusnoor, Anita V ; Singh, Hardeep
• Description:
  Objective:
  
  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.
  
  Methods:
  
  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.
  
  Results:
  
  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< .001), confidence in decisions (7.5 vs 6.3 out of 10; P< .001), and vignette completion time (3:02 vs 3:53 min.; P = .06). Physicians reported positive perceptions of the app’s potential for improved clinical decision making, and recommended it be used to address broader diagnostic challenges.
  
  Conclusions:
  
  A mobile app, PTT Advisor, may contribute to better test ordering and diagnosis, serve as a learning tool for diagnostic evaluation of certain clinical disorders, and improve patient outcomes. Similar methods could be useful for evaluating apps aimed at improving testing and diagnosis for other conditions.
  
  
• 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

  More +
• Source:
  J Am Med Inform Assoc. 25(7):841-847
• Pubmed ID:
  29688391
• Pubmed Central ID:
  PMC6947660
• Document Type:
  Journal Article
• Funding:
  CC999999/ImCDC/Intramural CDC HHS/United States ; R01 HS022087/HS/AHRQ HHS/United States ; R21 HS023602/HS/AHRQ HHS/United States
• Place as Subject:
  United States
• Volume:
  25
• Issue:
  7
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha256:93b910447a4a183d8805094e495d711d6cdb59ae7cfc67f047c2fa57bfbeced8
• Download URL:
  https://stacks.cdc.gov/view/cdc/84106/cdc_84106_DS1.pdf
• File Type:
  [PDF - 477.29 KB ]