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Human Information Processing, Health Information Technology, and Medical Outcomes—Reply
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In Reply: Dr Wilkinson makes 2 points: that our emphasis on explicit algorithms warrants refinement, and that we should not dismiss the importance of subjective input. We agree that health care delivery is tremendously complex, and as a result physicians often find themselves in uncharted waters. Indeed, even when prior evidence exists and has been incorporated into an explicit treatment algorithm, it is still necessary to decide whether the algorithm truly applies to the individual patient. We therefore view all algorithms as tools that transform past information into predictions.1-3 Since any attempt to predict the future is flawed, we agree with Wilkinson that all algorithms require continual analysis and refinement.
However, we remain committed to the continual refinement of explicit algorithms because they are the best means of achieving and sustaining long-term gains in performance. Implicit algorithms are the mental models an individual uses to select his or her response . . . [Full Text of this Article]
James R. Duncan, MD, PhD
duncanj@mir.wustl.edu
Ronald G. Evens, MD
Mallinckrodt Institute of Radiology
Washington University School of Medicine
St Louis, Missouri
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RELATED ARTICLE
Using Information to Optimize Medical Outcomes
James R. Duncan and Ronald G. Evens
JAMA. 2009;301(22):2383-2385.
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Human Information Processing, Health Information Technology, and Medical Outcomes
Thomas M. Wilkinson
JAMA. 2009;302(13):1417.
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