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Arch Emerg Med. 1993 December; 10(4): 314–320.
PMCID: PMC1286040

Computer aided diagnosis of abdominal pain: implementation difficulties in the North Western Region.


During 1987 a system for the computer-aided diagnosis of abdominal pain was introduced on a trial basis in seven district health authorities in the North Western (NW) Region. Despite good reports of the system from other areas, by the end of a 12-month period only two of the seven districts continued to use it in the routine management of patients. A study was undertaken to determine the difficulties that had been encountered and the way in which these had hindered successful implementation of the system. Information was obtained by interview with key personnel involved in the trial, which included the chief executive in each district, a consultant designated as responsible for the system and clerical staff. The study identified three main factors undermining the implementation of the system: a lack of consultant support; the negative attitude of junior doctors; and inadequate clerical support.

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Selected References

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  • Adams ID, Chan M, Clifford PC, Cooke WM, Dallos V, de Dombal FT, Edwards MH, Hancock DM, Hewett DJ, McIntyre N, et al. Computer aided diagnosis of acute abdominal pain: a multicentre study. Br Med J (Clin Res Ed) 1986 Sep 27;293(6550):800–804. [PMC free article] [PubMed]
  • Balla JI, Elstein AS, Christensen C. Obstacles to acceptance of clinical decision analysis. BMJ. 1989 Mar 4;298(6673):579–582. [PMC free article] [PubMed]
  • de Dombal FT, Leaper DJ, Staniland JR, McCann AP, Horrocks JC. Computer-aided diagnosis of acute abdominal pain. Br Med J. 1972 Apr 1;2(5804):9–13. [PMC free article] [PubMed]
  • de Dombal FT, Dallos V, McAdam WA. Can computer aided teaching packages improve clinical care in patients with acute abdominal pain? BMJ. 1991 Jun 22;302(6791):1495–1497. [PMC free article] [PubMed]
  • Horrocks JC, McCann AP, Staniland JR, Leaper DJ, De Dombal FT. Computer-aided diagnosis: description of an adaptable system, and operational experience with 2,034 cases. Br Med J. 1972 Apr 1;2(5804):5–9. [PMC free article] [PubMed]

Articles from Archives of Emergency Medicine are provided here courtesy of BMJ Group