, Volume 25, Issue 4, pp 282-283

Medical Decision Making: What Do We Trust?

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As computers become increasingly powerful, ubiquitous, and integrated into clinical practice, it seems logical that health professionals should use them to support their clinical practice. Unfortunately, the benefits of computerized clinical decision support have not yet been fully realized.1 In this issue of JGIM, Medow et al. report a study attempting to clarify our understanding of this problem.2 Medical residents first committed to a course of action (admit a hypothetical patient with pneumonia to the floor or the intensive care unit) and then received management advice that contradicted their decision. The “intervention” in this study was the source of advice–either an “expert pulmonologist” or a “decision aid” message citing an evidence-based prediction rule (the case was constructed so that two prediction rules3,4 would each justify a different management approach). The investigators found that residents paid more attention to the decision aid, suggesting that the failure to inc