Why are expert diagnostic decision support systems not integrated into clinical settings ? (Select all that apply.)

a. They have not been shown to be comparable to the performance of human experts.
b. Clinicians generally must go out of their routine workflows to use the systems, and these systems generally require time-consuming data entry.
c. There are limited financial incentives to use such systems.
d. The systems have been found to be detrimental to patient care.


ANS: B, C
There has been a lot of attention and promise on diagnostic decision support systems, including trials showing how they could outperform clinician experts. However, as discussed in other sections of the chapter, systems that are misaligned with the clinician's workflow and limited financial incentives are reasons for limited use of diagnostic CDS systems. Diagnostic CDS can be comparable to human experts when used appropriately. Also, these systems have not been found to be detrimental to patient care.

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