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01.12.2017 | Research article | Ausgabe 1/2017 Open Access

BMC Medical Informatics and Decision Making 1/2017

Automation bias in electronic prescribing

Zeitschrift:
BMC Medical Informatics and Decision Making > Ausgabe 1/2017
Autoren:
David Lyell, Farah Magrabi, Magdalena Z. Raban, L.G. Pont, Melissa T. Baysari, Richard O. Day, Enrico Coiera
Wichtige Hinweise

Electronic supplementary material

The online version of this article (doi:10.​1186/​s12911-017-0425-5) contains supplementary material, which is available to authorized users.

Abstract

Background

Clinical decision support (CDS) in e-prescribing can improve safety by alerting potential errors, but introduces new sources of risk. Automation bias (AB) occurs when users over-rely on CDS, reducing vigilance in information seeking and processing. Evidence of AB has been found in other clinical tasks, but has not yet been tested with e-prescribing. This study tests for the presence of AB in e-prescribing and the impact of task complexity and interruptions on AB.

Methods

One hundred and twenty students in the final two years of a medical degree prescribed medicines for nine clinical scenarios using a simulated e-prescribing system. Quality of CDS (correct, incorrect and no CDS) and task complexity (low, low + interruption and high) were varied between conditions. Omission errors (failure to detect prescribing errors) and commission errors (acceptance of false positive alerts) were measured.

Results

Compared to scenarios with no CDS, correct CDS reduced omission errors by 38.3% (p < .0001, n = 120), 46.6% (p < .0001, n = 70), and 39.2% (p < .0001, n = 120) for low, low + interrupt and high complexity scenarios respectively. Incorrect CDS increased omission errors by 33.3% (p < .0001, n = 120), 24.5% (p < .009, n = 82), and 26.7% (p < .0001, n = 120). Participants made commission errors, 65.8% (p < .0001, n = 120), 53.5% (p < .0001, n = 82), and 51.7% (p < .0001, n = 120). Task complexity and interruptions had no impact on AB.

Conclusions

This study found evidence of AB omission and commission errors in e-prescribing. Verification of CDS alerts is key to avoiding AB errors. However, interventions focused on this have had limited success to date. Clinicians should remain vigilant to the risks of CDS failures and verify CDS.
Zusatzmaterial
Additional file 1: Appendix A Overview of prescribing scenarios and Appendix B Example of an interruption task. (PDF 113 kb)
12911_2017_425_MOESM1_ESM.pdf
Literatur
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