Abstract
BackgroundCorrect diagnosis in psychiatry may be improved by novel diagnostic procedures. Computerized Decision Support Systems (CDSS) are suggested to be able to improve diagnostic procedures, but some studies indicate possible problems. Therefore, it could be important to investigate CDSS systems with regard to their feasibility to improve diagnostic procedures as well as to save time.MethodsThis study was undertaken to compare the traditional 'paper and pencil' diagnostic method SCID1 with the computer-aided diagnostic system CB-SCID1 to ascertain processing time and accuracy of diagnoses suggested. 63 clinicians volunteered to participate in the study and to solve two paper-based cases using either a CDSS or manually.ResultsNo major difference between paper and pencil and computer-supported diagnosis was found. Where a difference was found it was in favour of paper and pencil. For example, a significantly shorter time was found for paper and pencil for the difficult case, as compared to computer support. A significantly higher number of correct diagnoses were found in the diffilt case for the diagnosis 'Depression' using the paper and pencil method. Although a majority of the clinicians found the computer method supportive and easy to use, it took a longer time and yielded fewer correct diagnoses than with paper and pencil.ConclusionThis study could not detect any major difference in diagnostic outcome between traditional paper and pencil methods and computer support for psychiatric diagnosis.Where there were significant differences, traditional paper and pencil methods were better than the tested CDSS and thus we conclude that CDSS for diagnostic procedures may interfere with diagnosis accuracy. A limitation was that most clinicians had not previously used the CDSS system under study. The results of this study, however, confirm that CDSS development for diagnostic purposes in psychiatry has much to deal with before it can be used for routine clinical purposes.
Highlights
Correct diagnosis in psychiatry may be improved by novel diagnostic procedures
Where there were significant differences, traditional paper and pencil methods were better than the tested Computerized Decision Support Systems (CDSS) and we conclude that CDSS for diagnostic procedures may interfere with diagnosis accuracy
There was a significant correlation between DSM training and diagnostic outcome for the clinicians who solved the easy case using computer support and the difficult case using paper and pencil concerning total number of diagnoses (r = -0.39) and incorrect diagnoses (r = -0.37) for the difficult case
Summary
It may be important to investigate the fairly new CDSS system CB-SCID1 regarding its feasibility to improve the level of diagnostic success as well as the possibility of saving time. This study was undertaken to compare the traditional 'paper and pencil' diagnostic method SCID1 with the computer-aided diagnostic system CB-SCID1 with regard to processing time and the accuracy of suggested diagnoses
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