Call for wider use of decision support

A charity is calling for more widespread use of decision support systems in general practice after a survey it commissioned found nearly two out of three patients fear being misdiagnosed when they go to see their GP.

Doubts have been voiced, however, about the usability of decision support systems in general practice.

The Isabel Medical Charity, which developed the Isabel decision system now marketed by the charity’s trading subsidiary Isabel Healthcare, said the survey results had prompted it to step up its campaign for the widespread adoption of diagnostic support systems within the NHS.

The online survey of 2155 adults, conducted by YouGov in October last year, found that 60% of respondents fear illnesses will not be correctly diagnosed when they visit their GP. Those who completed the survey were also concerned about misdiagnosis when undergoing treatment at an NHS hospital with 31% saying this was the type of medical mistake which concerns them most.

The charity said that decision support systems were only scheduled for the final phases Connecting for Health’s programme which would mean delivery by 2009 at the earliest even though the systems are available and working today.

Sir Brian Jarman, former president of the BMA and head of the Dr Foster Unit at Imperial College, London, said: “Although Connecting for Health’s delivery timetable is centred around big projects like Choose and Book it could be very helpful for clinicians if practically and clinically proven systems like Isabel, which I understand could be put to practical use immediately, were to be more generally available.”

However Dr Paul Cundy, chairman of the British Medical Association’s GP IT committee, claimed decision support systems were not terribly helpful in general practice.

He told EHI Primary Care: “Decision support systems can be very sensitive where there is lots of non-subjective information going into them but that isn’t the case in general practice. There are many people who have tried to develop decision support for general practice but I don’t see it working at the moment.”

The Isabel medical charity was founded in 1999 by Jason and Charlotte Maude, who say they decided to set up a project to develop a decision support system, along with paediatric intensive care consultant Dr Joseph Britto, after their three year old daughter spent two months in hospital, including a month in intensive care, because doctors had failed to recognise the symptoms she was developing were potentially fatal complications of chicken pox.

The resulting decision support system Isabel, firstly developed for use in paediatrics, now covers all age groups and major medical specialties and is used in hospitals in the UK, US, Ireland and India.