{"doi":"10.2196/25046","title":"Barriers to the Use of Clinical Decision Support for the Evaluation of Pulmonary Embolism: Qualitative Interview Study","abstract":"BACKGROUND: Clinicians often disregard potentially beneficial clinical decision support (CDS). OBJECTIVE: In this study, we sought to explore the psychological and behavioral barriers to the use of a CDS tool. METHODS: We conducted a qualitative study involving emergency medicine physicians and physician assistants. A semistructured interview guide was created based on the Capability, Opportunity, and Motivation-Behavior model. Interviews focused on the barriers to the use of a CDS tool built based on Wells' criteria for pulmonary embolism to assist clinicians in establishing pretest probability of pulmonary embolism before imaging. RESULTS: Interviews were conducted with 12 clinicians. Six barriers were identified, including (1) Bayesian reasoning, (2) fear of missing a pulmonary embolism, (3) time pressure or cognitive load, (4) gestalt includes Wells' criteria, (5) missed risk factors, and (6) social pressure. CONCLUSIONS: Clinicians highlighted several important psychological and behavioral barriers to CDS use. Addressing these barriers will be paramount in developing CDS that can meet its potential to transform clinical care.","journal":"JMIR Human Factors","year":2021,"id":178324,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":19,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9591,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2021-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":445920,"name":"Katherine L Dauber-Decker","orcid":"0000-0002-0498-8779","position":1,"is_corresponding":false},{"id":94668,"name":"Thomas McGinn","orcid":"0000-0003-1005-227X","position":2,"is_corresponding":false},{"id":94671,"name":"Douglas P. Barnaby","orcid":"0000-0002-2135-0224","position":3,"is_corresponding":false},{"id":315466,"name":"Adithya Cattamanchi","orcid":"0000-0002-6553-2601","position":4,"is_corresponding":false},{"id":495667,"name":"Renée Pekmezaris","orcid":"0000-0003-2731-6489","position":5,"is_corresponding":false},{"id":94664,"name":"Safiya Richardson","orcid":"0000-0002-8576-1102","position":0,"is_corresponding":true}],"reference_count":34,"raw_metadata":null,"created_at":"2026-07-18T23:47:36.112170Z","pmid":"34346901","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}