Decision-making and decision support in acute care

Clinical Decision Support Systems (CDSS) are information tools intended to optimize medical choice, promising better patient outcomes, faster care, reduced resource expenditure, or some combination of all three. Clinical trials of CDSS have provided only insipid evidence of benefit to date. This chapter reviews the theory of medical decision-decision making, identifying the different decision support needs of novices and experts, and demonstrates that discipline, objective and setting, and affect of the nature of support that is required. A discussion on categorization attempts to provide metrics by which systems can be compared and evaluated, in particular with regard to decision support mechanics and function. Throughout, the common theme is the placement of clinical decision makers at the center of the design or evaluation process.