Abstract
Objectives. The authors sought to develop a conceptual framework for evaluating whether existing information technologies and decision support systems (IT/DSSs) would assist the key decisions faced by clinicians and public health officials preparing for and responding to bioterrorism. Methods. They reviewed reports of natural and bioterrorism-related infectious outbreaks, bioterrorism preparedness exercises, and advice from experts to identify the key decisions, tasks, and information needs of clinicians and public health officials during a bioterrorism response. The authors used task decomposition to identify the subtasks and data requirements of IT/DSSs designed to facilitate a bioterrorism response. They used the results of the task decomposition to develop evaluation criteria for IT/DSSs for bioterrorism preparedness. They then applied these evaluation criteria to 341 reports of 217 existing lT/DSSs that could be used to support a bioterrorism response. Main Results. In response to bioterrorism, clinicians must make decisions in 4 critical domains (diagnosis, management, prevention, and reporting to public health), and public health officials must make decisions in 4 other domains (interpretation of bioterrorism surveillance data, outbreak investigation, outbreak control, and communication). The time horizons and utilityfunctions for these decisions differ. From the task decomposition, the authors identified critical subtasks for each of the 8 decisions. For example, interpretation of diagnostic tests is an important subtask of diagnostic decision making that requires an understanding of the tests' sensitivity and specificity. Therefore, an evaluation criterion applied to reports of diagnostic IT/DSSs for bioterrorism asked whether the reports described the systems' sensitivity and specificity. Of the 217 existing IT/DSSs that could be used to respond to bioterrorism, 79 studies evaluated 58 systems for at least 1 performance metric. Conclusions. The authors identified 8 key decisions that clinicians and public health officials must make in response to bioterrorism. When applying the evaluation system to 217 currently available IT/DSSs that could potentially support the decisions of clinicians and public health officials, the authors found that the literature provides little information about the accuracy of these systems.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 192-206 |
| Number of pages | 15 |
| Journal | Medical Decision Making |
| Volume | 24 |
| Issue number | 2 |
| DOIs | |
| State | Published - Mar 1 2004 |
| Externally published | Yes |
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Keywords
- Bioterrorism
- Decision support techniques
- Expert system
- Information systems
- Public health
ASJC Scopus subject areas
- Health Policy
Cite this
A Conceptual Framework for Evaluating Information Technologies and Decision Support Systems for Bioterrorism Preparedness and Response. / Bravata, Dena M.; McDonald, Kathryn M.; Szeto, Herbert; Smith, Wendy M.; Rydzak, Chara; Owens, Douglas K.
In: Medical Decision Making, Vol. 24, No. 2, 01.03.2004, p. 192-206.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - A Conceptual Framework for Evaluating Information Technologies and Decision Support Systems for Bioterrorism Preparedness and Response
AU - Bravata, Dena M.
AU - McDonald, Kathryn M.
AU - Szeto, Herbert
AU - Smith, Wendy M.
AU - Rydzak, Chara
AU - Owens, Douglas K.
PY - 2004/3/1
Y1 - 2004/3/1
N2 - Objectives. The authors sought to develop a conceptual framework for evaluating whether existing information technologies and decision support systems (IT/DSSs) would assist the key decisions faced by clinicians and public health officials preparing for and responding to bioterrorism. Methods. They reviewed reports of natural and bioterrorism-related infectious outbreaks, bioterrorism preparedness exercises, and advice from experts to identify the key decisions, tasks, and information needs of clinicians and public health officials during a bioterrorism response. The authors used task decomposition to identify the subtasks and data requirements of IT/DSSs designed to facilitate a bioterrorism response. They used the results of the task decomposition to develop evaluation criteria for IT/DSSs for bioterrorism preparedness. They then applied these evaluation criteria to 341 reports of 217 existing lT/DSSs that could be used to support a bioterrorism response. Main Results. In response to bioterrorism, clinicians must make decisions in 4 critical domains (diagnosis, management, prevention, and reporting to public health), and public health officials must make decisions in 4 other domains (interpretation of bioterrorism surveillance data, outbreak investigation, outbreak control, and communication). The time horizons and utilityfunctions for these decisions differ. From the task decomposition, the authors identified critical subtasks for each of the 8 decisions. For example, interpretation of diagnostic tests is an important subtask of diagnostic decision making that requires an understanding of the tests' sensitivity and specificity. Therefore, an evaluation criterion applied to reports of diagnostic IT/DSSs for bioterrorism asked whether the reports described the systems' sensitivity and specificity. Of the 217 existing IT/DSSs that could be used to respond to bioterrorism, 79 studies evaluated 58 systems for at least 1 performance metric. Conclusions. The authors identified 8 key decisions that clinicians and public health officials must make in response to bioterrorism. When applying the evaluation system to 217 currently available IT/DSSs that could potentially support the decisions of clinicians and public health officials, the authors found that the literature provides little information about the accuracy of these systems.
AB - Objectives. The authors sought to develop a conceptual framework for evaluating whether existing information technologies and decision support systems (IT/DSSs) would assist the key decisions faced by clinicians and public health officials preparing for and responding to bioterrorism. Methods. They reviewed reports of natural and bioterrorism-related infectious outbreaks, bioterrorism preparedness exercises, and advice from experts to identify the key decisions, tasks, and information needs of clinicians and public health officials during a bioterrorism response. The authors used task decomposition to identify the subtasks and data requirements of IT/DSSs designed to facilitate a bioterrorism response. They used the results of the task decomposition to develop evaluation criteria for IT/DSSs for bioterrorism preparedness. They then applied these evaluation criteria to 341 reports of 217 existing lT/DSSs that could be used to support a bioterrorism response. Main Results. In response to bioterrorism, clinicians must make decisions in 4 critical domains (diagnosis, management, prevention, and reporting to public health), and public health officials must make decisions in 4 other domains (interpretation of bioterrorism surveillance data, outbreak investigation, outbreak control, and communication). The time horizons and utilityfunctions for these decisions differ. From the task decomposition, the authors identified critical subtasks for each of the 8 decisions. For example, interpretation of diagnostic tests is an important subtask of diagnostic decision making that requires an understanding of the tests' sensitivity and specificity. Therefore, an evaluation criterion applied to reports of diagnostic IT/DSSs for bioterrorism asked whether the reports described the systems' sensitivity and specificity. Of the 217 existing IT/DSSs that could be used to respond to bioterrorism, 79 studies evaluated 58 systems for at least 1 performance metric. Conclusions. The authors identified 8 key decisions that clinicians and public health officials must make in response to bioterrorism. When applying the evaluation system to 217 currently available IT/DSSs that could potentially support the decisions of clinicians and public health officials, the authors found that the literature provides little information about the accuracy of these systems.
KW - Bioterrorism
KW - Decision support techniques
KW - Expert system
KW - Information systems
KW - Public health
UR - http://www.scopus.com/inward/record.url?scp=1642380826&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=1642380826&partnerID=8YFLogxK
U2 - 10.1177/0272989X04263254
DO - 10.1177/0272989X04263254
M3 - Article
C2 - 15090105
AN - SCOPUS:1642380826
VL - 24
SP - 192
EP - 206
JO - Medical decision making : an international journal of the Society for Medical Decision Making
JF - Medical decision making : an international journal of the Society for Medical Decision Making
SN - 0272-989X
IS - 2
ER -