Distributed decision support using a Web-based interface: Prevention of sudden cardiac death

Although decision models can provide a formal foundation for guideline deve lopment and clinical decision support, their widespread use is often limite d by the lack of platform-independent software that geographically disperse d users can access and use easily without extensive training. To address th ese limitations the authors developed a World Wide Web-based interface for previously developed decision models. They describe the use and functionali ty of the interface using a decision model that evaluates the cost-effectiv eness of strategies for preventing sudden cardiac death. The system allows an analyst to use a web browser to interact with the decision model and to change the values of input variables within pre-specified ranges, to specif y sensitivity or threshold analyses, to evaluate the decision model, and to view the results generated dynamically. The web site also provides linkage s to an explanation of the model, and evidence tables for input variables. The system demonstrates a method for providing distributed decision support to remote users such as guideline developers, decision analysts, and poten tially practicing physicians. The web interface provides platform-independe nt and almost universal access to a decision model. This approach can make distributed decision support both practical and economical, and has the pot ential to increase the usefulness of decision models by enabling a broader audience to incorporate systematic analyses into both policy and clinical d ecisions.