Where support ends and substitution begins.
WHAT CLINICAL DECISION SUPPORT IS
Systems that surface information relevant to a decision: guidelines, interactions, risk scores.
WHAT IS LEGITIMATE
Flagging a possible interaction for you to consider Surfacing a relevant guideline Reminding of a screening interval Highlighting an abnormal result
WHAT IS NOT
A system determining the diagnosis A system determining the treatment Acting on a suggestion without independent clinical reasoning
THE CENTRAL DISTINCTION
Support brings information to your attention. Substitution makes the decision.
Only the first is appropriate.
THE AUTOMATION BIAS PROBLEM
Clinicians who receive a suggestion tend to accept it, including when it is wrong.
That is documented and it is the main risk of decision support.
Reason independently first, then consider the suggestion.
WHAT TO BE ESPECIALLY CAREFUL WITH
General language models used for clinical questions. They are not validated clinical tools.
They produce confident answers about dosing, interactions and management that may be wrong.
WHAT TO USE INSTEAD
Validated clinical references, for anything affecting care.
