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Table 8 Classification of performance gaps and CDS opportunities based on median ratings and statistical agreement, by rating criterion

From: A conceptual framework and protocol for defining clinical decision support objectives applicable to medical specialties

  Rating Criterion Rating result
Median: 1-3 AND No Disagreement* Median: 4-6 OR Disagreement Median: 7-9 AND
Indeterminate Agreement Agreement**
Performance gaps Importance Unimportant Equivocal Important Important – highest priority
CDS opportunities Compatibility Incompatible with clinical practice Equivocal Compatible with clinical practice Compatible with clinical practice – highest priority
Potential impact Low potential impact Equivocal High potential impact High potential impact – highest priority
  1. *“No disagreement” implies either “agreement” or “indeterminate agreement”.
  2. **While the RAND/UCLA Appropriateness Manual (RAM) only requires median ratings in the 7-9 range and the absence of disagreement to classify items as high priority, we used a higher bar, by requiring that each criterion exhibit statistical agreement. Items with indeterminate levels of agreement were not considered high priority.