Comparison of two kinds of interface, based on guided navigation or usability principles, for improving the adoption of computerized decision support systems: application to the prescription of antibiotics

J Am Med Inform Assoc. 2014 Feb;21(e1):e107-16. doi: 10.1136/amiajnl-2013-002042. Epub 2013 Sep 5.


Context: It is important to consider the way in which information is presented by the interfaces of clinical decision support systems, to favor the adoption of these systems by physicians. Interface design can focus on decision processes (guided navigation) or usability principles.

Objective: The aim of this study was to compare these two approaches in terms of perceived usability, accuracy rate, and confidence in the system.

Materials and methods: We displayed clinical practice guidelines for antibiotic treatment via two types of interface, which we compared in a crossover design. General practitioners were asked to provide responses for 10 clinical cases and the System Usability Scale (SUS) for each interface. We assessed SUS scores, the number of correct responses, and the confidence level for each interface.

Results: SUS score and percentage confidence were significantly higher for the interface designed according to usability principles (81 vs 51, p=0.00004, and 88.8% vs 80.7%, p=0.004). The percentage of correct responses was similar for the two interfaces.

Discussion/conclusion: The interface designed according to usability principles was perceived to be more usable and inspired greater confidence among physicians than the guided navigation interface. Consideration of usability principles in the construction of an interface--in particular 'effective information presentation', 'consistency', 'efficient interactions', 'effective use of language', and 'minimizing cognitive load'--seemed to improve perceived usability and confidence in the system.

Keywords: Antibiotic prescription; Physicians, Primary care; Practice guideline; Usability; User-computer interface.

Publication types

  • Comparative Study

MeSH terms

  • Anti-Bacterial Agents / therapeutic use*
  • Attitude of Health Personnel
  • Attitude to Computers*
  • Decision Support Systems, Clinical / statistics & numerical data*
  • Drug Therapy, Computer-Assisted / statistics & numerical data*
  • Humans
  • Physicians, Family
  • Practice Guidelines as Topic
  • User-Computer Interface*


  • Anti-Bacterial Agents