Computer decision support changes physician practice but not knowledge regarding autism spectrum disorders

Nerissa S. Bauer, A. E. Carroll, C. Saha, S. M. Downs

Research output: Contribution to journalArticle

9 Scopus citations


Objective: To examine whether adding an autism module promoting adherence to clinical guidelines to an existing computer decision support system (CDSS) changed physician knowledge and self-reported clinical practice. Methods: The CHICA (Child Health Improvement through Computer Automation) system, a CDSS, was enhanced with a module to improve management of autism in 2 of the 4 community pediatric clinics using the system. We examined the knowledge and beliefs of pediatric users using cross-sectional surveys administered at 3 time points (baseline, 12 months and 24 months post-implementation) between November 2010 and January 2013. Surveys measured knowledge, beliefs and selfreported practice patterns related to autism. Results: A total of 45, 39, and 42 pediatricians responded at each time point, respectively, a 95-100% response rate. Respondents’ knowledge of autism and perception of role for diagnosis did not vary between control and intervention groups either at baseline or any of the two post-intervention time points. At baseline, there was no difference between these groups in rates in the routine use of parent-rated screening instruments for autism. However, by 12 and 24 months postimplementation there was a significant difference between intervention and control clinics in terms of the intervention clinics consistently screening eligible patients with a validated autism tool. Physicians at all clinics reported ongoing challenges to community resources for further work-up and treatment related to autism. Conclusions: A CDSS module to improve primary care management of ASD in pediatric practice led to significant improvements in physician-reported use of validated screening tools to screen for ASDs. However it did not lead to corresponding changes in physician knowledge or attitudes.

Original languageEnglish (US)
Pages (from-to)454-465
Number of pages12
JournalApplied clinical informatics
Issue number3
StatePublished - Jul 15 2015


  • Autism spectrum disorder
  • Clinical guidelines
  • Computer-based decision support
  • Pediatrics
  • Primary care
  • Screening

ASJC Scopus subject areas

  • Health Informatics
  • Computer Science Applications
  • Health Information Management

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