This Article Full Text (PDF) References Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Saved Citations Download to citation manager Request Permissions Request Reprints Add to My Marked Citations Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Citing Articles via Scopus Google Scholar Articles by Dayton, C. S. Articles by Peterson, M. W. Search for Related Content PubMed PubMed Citation Articles by Dayton, C. S. Articles by Peterson, M. W. Social Bookmarking                   What's this?

Evaluation of an Internet-based Decision-support System for Applying the ATS/CDC Guidelines for Tuberculosis Preventive Therapy

J. Scott Ferguson, MD

Douglas B. Hornick, MD

Michael W. Peterson, MD

Preventive therapy for patients infected with tuberculosis (TB) remains an important component of TB control. To guide physicians in applying preventive therapy, the American Thoracic Society and Centers for Disease Control (ATS/CDC) developed guidelines based on PPD reactivity and on pretest probability of infection. The guidelines have become complex, and many clinicians find them challenging to apply. The authors developed a computerized decision-support system to assist clinicians in applying the ATS/CDC guidelines. This tool, published on the World Wide Web using hypertext markup language, delivers patient-specific recommendations based on physician-delivered patient-specific information. Four local TB experts derived eight TB infection scenarios and validated the web-based tool, which was tested for effectiveness using general internal medicine residents, randomly divided into two groups. Group A (n = 12) used the web-based tool and group B (n = 17) used pre-existing understanding of the guidelines and/or written resources to determine the need for preventive therapy in the case scenarios. Group A correctly used therapy in 92/96 possible cases (95.8%), group B in only 77/136 (56.6%) (p < 0.001). Group A required a mean of three mouse-clicks and 1.5 minutes per scenario to reach their choices, and they rated the web-based tool both intuitive and effective. These data demonstrate that a computer-based decision-support system for applying TB treatment guidelines can be delivered over the Internet and provide an efficient and effective resource for clinicians. Key words: decision-support system; practice guidelines; Internet; tuberculosis ; prevention. (Med Decis Making 2000;20:1-6)

Medical Decision Making, Vol. 20, No. 1, 1-6 (2000)
DOI: 10.1177/0272989X0002000101


CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this?

This article has been cited by other articles:

				J. Hornberger and M. Kane Goldstein Clinical Decision-support Systems:: Evaluating the Evaluation Med Decis Making, January 1, 2000; 20(1): 130 - 131. [PDF]