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Book ReviewOriginally published in The British Journal of Healthcare Computing & Information Management. |
Eta S. Berner (Ed.) (1999). Clinical Decision Support Systems: Theory and Practice. Springer Verlag: New York.
There was a paper that kept being refused publication until it changed its name to ``The computer will see you now''. This apparently exciting notion of a computer's clinical role is firmly scotched by the various chapter authors of ``Clinical Decision Support Systems'' (CDDS). As their name suggests, CDDSs support, not replace, the clinician.
With computers proliferating in the health services and the general public being encouraged to seek out information, CDDSs are becoming crucial. This is a very timely book. It provides information on their architectures, functions, real-world implementations, educational uses, ethical implications, and on evaluating their effectiveness. When attempting to cover such a large and multidisciplinary area, the book's remit needs to be clear. If it is to give an overview of many systems and the issues around how how they function in practice, then it is successful. It is less so when providing technical details about architectures and reasoning processes; either the readers already know about them, in which case the information is redundant, or they do not, in which case they will be little wiser. Hence the book should be considered more of a resource than a text book, despite its claims on the back cover.
As a resource, it is extremely valuable, with some of the chapters providing aposite and recent references. Some areas, as one would expect in such a diffuse field, are not covered so well. For example, there is a tendency to cite the original heuristics and biases research on human reasoning, rather than the later work which disputed its findings that people are invariably poor intuitive statisticians. But the worst example of an inappropriate reference is one suporting the assertion that few informatics applications have been evaluated in clinical settings: the reference date is 1987, twelve years before the book's publication. It would also have helped if the some of the authors had cited good textbooks to support technical issues rather than journal articles giving particular applications using the approaches. Some did, though, and because the book collates all chapter references into a complete set at the end, the overall impression is of a highly useful map and compass to the diverse, complex area of clinical decision support systems.