Nils Kucher et al.
The New England Journal of Medicine
March 10, 2005, Vol. 352, Issue #10, pg. 969-977.
Review by: Scott Helf, D.O. <shelf@western.edu>
COMMENTS: Drs. Kucher et. al. report the significant decrease in the incidence of venous thrombosis in hospitalized patients, via the use of a computer aided decision tool, which, after identifying patients at increased risk for deep venous thrombosis, forces the attending physician to enter orders to treat or not treat. ANALYSIS: While medicine largely remains an art, many acute and chronic conditions lend themselves to "standard of care" algorithms that are in wide spread use because they have shown their efficacy. The modular development of software algorithms which, like the authors' solution, force or strongly influence health professionals to make clinical decisions is a huge step in improving the quality of medicine. The challenges are to develop and continually improve the algorithms used--and to determine upon who's collective intelligence and knowledge these are built, modularizing these softwares so that they integrate and build on existing and future platforms, establishing "universal" database structures and / or data interpreters, training future health care professionals how to use and develop future algorithms, and establishing and managing the legal risk to the practitioner, institution, software company and its developers, whom opt to use, or not used, such algorithms.
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