Evidence-based decision support for neurological diagnosis reduces errors and unnecessary workup

J Child Neurol. 2014 Apr;29(4):487-92. doi: 10.1177/0883073813483365. Epub 2013 Apr 10.


Using vignettes of real cases and the SimulConsult diagnostic decision support software, neurologists listed a differential diagnosis and workup before and after using the decision support. Using the software, there was a significant reduction in error, up to 75% for diagnosis and 56% for workup. This error reduction occurred despite the baseline being one in which testers were allowed to use narrative resources and Web searching. A key factor that improved performance was taking enough time (>2 minutes) to enter clinical findings into the software accurately. Under these conditions and for instances in which the diagnoses changed based on using the software, diagnostic accuracy improved in 96% of instances. There was a 6% decrease in the number of workup items accompanied by a 34% increase in relevance. The authors conclude that decision support for a neurological diagnosis can reduce errors and save on unnecessary testing.

Keywords: decision support; diagnosis; errors; genetics; medical informatics; neurogenetics.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Decision Making, Computer-Assisted*
  • Diagnosis, Differential
  • Diagnostic Errors / prevention & control*
  • Diagnostic Errors / statistics & numerical data
  • Evidence-Based Medicine*
  • Female
  • Humans
  • Internet
  • Male
  • Nervous System Diseases / diagnosis*
  • Software