Clinician decisions and computers.

The clinician's decisions are subject to numerous distorting influences. Computer decision aids can help avoid these distortions by placing the clinician's limited personal experience into broader perspective through comparison with a larger repository of clinically relevant information; by making explicit the assumptions implied by his or her decisions; and by alerting the clinician whenever the decisions made do not appear consistent with these assumptions, with the available information or with the conventional rules of logic. Practical standards of performance with respect to the development, validation and clinical application of these decision aids are still in evolution, however, and a variety of ethical and legal issues have yet to be addressed. Despite the promise of computer decision aids, it remains to be seen whether their diffusion into medical practice will improve the quality and cost of health care.