Exploring differential diagnosis decision support systems for trainee advanced practitioners in primary care
evidence and practice    

Exploring differential diagnosis decision support systems for trainee advanced practitioners in primary care

Chris McParland PhD student (nursing), School of Medicine, Dentistry and Nursing, University of Glasgow and research nurse, Glasgow Clinical Research Facility, NHS Greater Glasgow and Clyde, Scotland
Mark Cooper Nurse consultant advanced practice, NHS Greater Glasgow and Clyde and honorary senior clinical lecturer, University of Glasgow, Scotland
Bridget Johnston Florence Nightingale Foundation clinical professor of nursing, University of Glasgow and NHS Greater Glasgow and Clyde, Scotland

Why you should read this article:
  • To increase your awareness of differential diagnosis decision support systems

  • To learn about the research base for differential diagnosis decision support systems

  • To understand how decision support systems could aid trainee advanced practitioners in primary care

Background In primary care, advanced practitioners from nursing and allied health professions are increasingly deployed to assess, diagnose and manage patients. Differential diagnosis decision support systems may assist trainee advanced practitioners with developing their diagnostic decision-making skills.

Aim To identify which differential diagnosis decision support systems are available to primary care clinicians; review the literature regarding these systems; and identify their positive and negative aspects from the perspective of trainee advanced practitioners in primary care.

Method Market research and a literature review were conducted to identify and explore available systems. In an earlier, larger study, focus groups had been conducted with GPs, advanced practitioners and members of the public. The findings from the focus groups are reported here from the perspective of trainee advanced practitioners.

Findings Four commercially available systems were identified – DXplain, Isabel, PEPID and VisualDx – and explored in terms of accuracy, speed and time efficiency, user feedback, use in education, and use in primary care. Focus group participants expressed the views that such systems could guide and confirm diagnostic decisions, but also raised concerns about their potential to stifle decision-making and inhibit critical thinking.

Conclusion In principle, trainee advanced practitioners are open to using differential diagnosis decision support systems, not necessarily to provide them with the knowledge they do not possess but rather to support and reassure them as they adapt to their new roles.

Primary Health Care. doi: 10.7748/phc.2020.e1665

Peer review

This article has been subject to external double-blind peer review and has been checked for plagiarism using automated software

Correspondence

c.mcparland.1@research.gla.ac.uk

Conflict of interest

None declared

McParland CR, Cooper MA, Johnston B (2020) Exploring differential diagnosis decision support systems for trainee advanced practitioners in primary care. Primary Health Care. doi: 10.7748/phc.2020.e1665

Acknowledgement

The authors would like to thank the focus group participants, the companies that participated in the market research activity, Dr Ann Wales, Scottish Government Digital Health and Care Directorate and Digital Health and Care Institute, research librarians Ruth Hamilton and Lynn Easton, and Annabel Farnood for her contribution to the original rapid review

Published online: 28 October 2020

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