Computer-aided DSM-IV-diagnostics – acceptance, use and perceived usefulness in relation to users' learning styles

BackgroundCDSS (computerized decision support system) for medical diagnostics have been studied for long. This study was undertaken to investigate how different preferences of Learning Styles (LS) of psychiatrists might affect acceptance, use and perceived usefulness of a CDSS for diagnostics in psychiatry.Methods49 psychiatrists (specialists and non-specialists) from 3 different clinics volunteered to participate in this study and to use the CDSS to diagnose a paper-based case (based on a real patient). LS, attitudes to CDSS and complementary data were obtained via questionnaires and interviews. To facilitate the study, a special version of the CDSS was created, which automatically could log interaction details.ResultsThe LS preferences (according to Kolb) of the 49 physicians turned out as follows: 37% were Assimilating, 31% Converging, 27% Accommodating and 6% Diverging.The CDSS under study seemed to favor psychiatrists with abstract conceptualization information perceiving mode (Assimilating and Converging learning styles).A correlation between learning styles preferences and computer skill was found. Positive attitude to computer-aided diagnostics and learning styles preferences was also found to correlate.Using the CDSS, the specialists produced only 1 correct diagnosis and the non-specialists 2 correct diagnoses (median values) as compared to the three predetermined correct diagnoses of the actual case. Only 10% had all three diagnoses correct, 41 % two correct, 47 % one correct and 2 % had no correct diagnose at all.ConclusionOur results indicate that the use of CDSS does not guarantee correct diagnosis and that LS might influence the results. Future research should focus on the possibility to create systems open to individuals with different LS preferences and possibility to create CDSS adapted to the level of expertise of the user.

[1]  Kenneth Gilhooly,et al.  Cognitive psychology and medical diagnosis , 1990 .

[2]  T. Brugha,et al.  SCAN. Schedules for Clinical Assessment in Neuropsychiatry. , 1990, Archives of general psychiatry.

[3]  L. Curry Cognitive and learning styles in medical education. , 1999, Academic medicine : journal of the Association of American Medical Colleges.

[4]  J. Endicott,et al.  DIAGNO. A computer program for psychiatric diagnosis utilizing the differential diagnostic procedure. , 1968, Archives of general psychiatry.

[5]  Corinne M. Karuppan,et al.  Web-based teaching materials: a user's profile , 2001, Internet Res..

[6]  Maung K. Sein,et al.  Learning Style and the Efficacy of Computer Training Methods , 1991 .

[7]  C. T. Wallace,et al.  Learning style analysis in surgical training. , 1985, The American surgeon.

[8]  H. Dreyfus Mind Over Machine , 1986 .

[9]  C. Claxton,et al.  Learning Styles: Implications for Improving Educational Practices. ASHE-ERIC Higher Education Report No. 4, 1987. , 1987 .

[10]  Edward H. Shortliffe,et al.  Computer-based medical consultations, MYCIN , 1976 .

[11]  Bryce Allen Individual differences and the conundrums of user-centered design: two experiments , 2000 .

[12]  M Fieschi,et al.  Medical Decision Support Systems: Old Dilemmas and new Paradigms? , 2003, Methods of Information in Medicine.

[13]  D. Kolb Experiential Learning: Experience as the Source of Learning and Development , 1983 .

[14]  Hubert L. Dreyfus,et al.  Mind over Machine: The Power of Human Intuition and Expertise in the Era of the Computer , 1987, IEEE Expert.

[15]  Timothy M. Franz,et al.  Enhancement of clinicians' diagnostic reasoning by computer-based consultation: a multisite study of 2 systems. , 1999, JAMA.

[16]  Mark S Plovnick,et al.  Individual learning styles and the process of career choice in medical students , 1975 .

[17]  Bryce Allen Individual differences and the conundrums of user-centered design: Two experiments , 2000, J. Am. Soc. Inf. Sci..

[18]  Anthony F. Grasha,et al.  A Rational Approach to Developing and Assessing the Construct Validity of a Student Learning Style Scales Instrument , 1974 .

[19]  Wendy L. Jordanov An Examination of the Relationship between Learning Style and Technology Use. , 2001 .

[20]  H. Belloc The Free Press , 2002 .

[21]  F. T. Dedombal Computer-aided diagnosis and decision-making in the acute abdomen. , 1975, Journal of the Royal College of Physicians of London.

[22]  Randolph A. Miller,et al.  Review: Medical Diagnostic Decision Support Systems - Past, Present, And Future: A Threaded Bibliography and Brief Commentary , 1994, J. Am. Medical Informatics Assoc..

[23]  M. Polanyi Chapter 7 – The Tacit Dimension , 1997 .

[24]  E S Berner,et al.  Relationships among performance scores of four diagnostic decision support systems. , 1996, Journal of the American Medical Informatics Association : JAMIA.

[25]  D R Wesson,et al.  Expert systems in treating substance abuse. , 1990, The Western journal of medicine.

[26]  G. Pask STYLES AND STRATEGIES OF LEARNING , 1976 .

[27]  deDombal Ft Computer-aided diagnosis and decision-making in the acute abdomen. , 1975 .

[28]  L. Curry An Organization of Learning Styles Theory and Constructs. , 1983 .

[29]  Eric Brown,et al.  Report no. 4 , 1873 .

[30]  S. Dreyfus,et al.  Making a mind versus modeling the brain: aritifical intelligence back at a branchpoint , 1989 .

[31]  B. Allen Cognitive Research in Information Science: Implications for Design , 1991 .

[32]  William Haseman,et al.  User attitude as a mediator of learning performance improvement in an interactive multimedia environment: an empirical investigation of the degree of interactivity and learning styles , 2001, Int. J. Hum. Comput. Stud..

[33]  L. Baldwin,et al.  Learning styles for interactive learning systems , 2003 .

[34]  M S Plovnick,et al.  Primary care career choices and medical student learning styles. , 1975, Journal of medical education.

[35]  C. Bell DSM-IV: Diagnostic and Statistical Manual of Mental Disorders , 1994 .

[36]  Gloria E. Melara,et al.  Investigating Learning Styles on Different Hypertext Environments: Hierarchical-like and Network-like Structures , 1996 .

[37]  R. Spitzer Dsm-IV Casebook: A Learning Companion to the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition , 1994 .

[38]  R. Engle,et al.  Attempts to Use Computers as Diagnostic Aids in Medical Decision Making: A Thirty-Year Experience , 2015, Perspectives in biology and medicine.

[39]  I. B. Myers The Myers-Briggs Type Indicator: Manual (1962). , 1962 .

[40]  Jacobus Ridderikhoff,et al.  Who is afraid of the system? Doctors' attitude towards diagnostic systems , 1999, Int. J. Medical Informatics.

[41]  Hsi-Peng Lu,et al.  The effects of cognitive style and model type on DSS acceptance: An empirical study , 2001, Eur. J. Oper. Res..