Which clinical decisions benefit from automation? A task complexity approach

International Journal of Medical Informatics
Vitali Sintchenko, Enrico W Coiera

Abstract

To describe a model for analysing complex medical decision making tasks and for evaluating their suitability for automation. Assessment of a decision task's complexity in terms of the number of elementary information processes (EIPs) and the potential for cognitive effort reduction through EIP minimisation using an automated decision aid. The model consists of five steps: (1) selection of the domain and relevant tasks; (2) evaluation of the knowledge complexity for tasks selected; (3) identification of cognitively demanding tasks; (4) assessment of unaided and aided effort requirements for this task accomplishment; and (5) selection of computational tools to achieve this complexity reduction. The model is applied to the task of antibiotic prescribing in critical care and the most complex components of the task identified. Decision aids to support these components can provide a significant reduction of cognitive effort suggesting this is a decision task worth automating. We view the role of decision support for complex decision to be one of task complexity reduction, and the model described allows for task automation without lowering decision quality and can assist decision support systems developers.

References

May 1, 1978·The American Journal of the Medical Sciences·D G Maki, A A Schuna
Sep 1, 1991·Family Practice·C P Bradley
Jan 1, 1995·Medical Decision Making : an International Journal of the Society for Medical Decision Making·R M PosesR S Wigton
Jun 26, 1998·BMJ : British Medical Journal·H HeathfieldR Hanka
Nov 24, 1998·Journal of the American Medical Informatics Association : JAMIA·V L Patel, D R Kaufman
Aug 3, 1999·Academic Medicine : Journal of the Association of American Medical Colleges·A S Elstein
Jun 1, 2000·Journal of the American Medical Informatics Association : JAMIA·Enrico W Coiera
Jan 13, 2001·International Journal of Technology Assessment in Health Care·G P Browman
Aug 8, 2001·Journal of Evaluation in Clinical Practice·B H Bornstein, A C Emler
Jun 18, 2003·International Journal of Medical Informatics·Enrico W Coiera

Citations

Oct 28, 2008·Journal of the American Medical Informatics Association : JAMIA·Martin C WereMichael Weiner
Aug 12, 2010·Journal of Health Organization and Management·Melanie JessupGerard Fitzgerald
Sep 6, 2013·Journal of the American Medical Informatics Association : JAMIA·Enrico W Coiera
Nov 16, 2014·BMC Medical Informatics and Decision Making·Huiqin YangMartin Bland
Apr 26, 2008·Journal of the American Medical Informatics Association : JAMIA·Enrico W Coiera, Victor Vickland
Oct 19, 2013·Internal Medicine Journal·T J Hannan, C Celia
Feb 9, 2011·International Journal of Medical Informatics·Charlene R WeirAshley N Hedeen
Jun 21, 2015·BMJ Quality & Safety·Enrico W Coiera
Aug 16, 2016·Journal of the American Medical Informatics Association : JAMIA·David Lyell, Enrico W Coiera
Apr 13, 2017·Applied Clinical Informatics·Christopher AakreVitaly Herasevich
Oct 27, 2010·International Journal of Technology Assessment in Health Care·Alejandro Enrique Flores ZunigaWilly Susilo
Jan 24, 2019·Health Informatics Journal·Ofir Ben-AssuliItamar Shabtai
Jun 15, 2006·Expert Review of Anti-infective Therapy·Karin Thursky
Jul 28, 2011·Methods of Information in Medicine·F MagrabiE Coeira
Mar 23, 2011·Drug Safety : an International Journal of Medical Toxicology and Drug Experience·Melissa T BaysariRichard O Day
Dec 23, 2016·Journal of Perinatology : Official Journal of the California Perinatal Association·M L McLandersH G Liley
Dec 2, 2015·BMC Medical Informatics and Decision Making·Roosan IslamMatthew H Samore

Related Concepts

Knowledge Representation (Computer)
Cognition
Medical Decision Making, Computer-Assisted

Trending Feeds

COVID-19

Coronaviruses encompass a large family of viruses that cause the common cold as well as more serious diseases, such as the ongoing outbreak of coronavirus disease 2019 (COVID-19; formally known as 2019-nCoV). Coronaviruses can spread from animals to humans; symptoms include fever, cough, shortness of breath, and breathing difficulties; in more severe cases, infection can lead to death. This feed covers recent research on COVID-19.

Chronic Fatigue Syndrome

Chronic fatigue syndrome is a disease characterized by unexplained disabling fatigue; the pathology of which is incompletely understood. Discover the latest research on chronic fatigue syndrome here.

Systemic Juvenile Idiopathic Arthritis

Systemic juvenile idiopathic arthritis is a rare rheumatic disease that affects children. Symptoms include joint pain, but also fevers and skin rashes. Here is the latest on this disease.

Chromatin Regulation and Circadian Clocks

The circadian clock plays an important role in regulating transcriptional dynamics through changes in chromatin folding and remodelling. Discover the latest research on Chromatin Regulation and Circadian Clocks here.

Central Pontine Myelinolysis

Central Pontine Myelinolysis is a neurologic disorder caused most frequently by rapid correction of hyponatremia and is characterized by demyelination that affects the central portion of the base of the pons. Here is the latest research on this disease.

Myocardial Stunning

Myocardial stunning is a mechanical dysfunction that persists after reperfusion of previously ischemic tissue in the absence of irreversible damage including myocardial necrosis. Here is the latest research.

Pontocerebellar Hypoplasia

Pontocerebellar hypoplasias are a group of neurodegenerative autosomal recessive disorders with prenatal onset, atrophy or hypoplasia of the cerebellum, hypoplasia of the ventral pons, microcephaly, variable neocortical atrophy and severe mental and motor impairments. Here is the latest research on pontocerebellar hypoplasia.

Cell Atlas Along the Gut-Brain Axis

Profiling cells along the gut-brain axis at the single cell level will provide unique information for each cell type, a three-dimensional map of how cell types work together to form tissues, and insights into how changes in the map underlie health and disease of the GI system and its crosstalk with the brain. Disocver the latest research on single cell analysis of the gut-brain axis here.

Chronic Traumatic Encephalopathy

Chronic Traumatic Encephalopathy (CTE) is a progressive degenerative disease that occurs in individuals that suffer repetitive brain trauma. Discover the latest research on traumatic encephalopathy here.