What's the "Walter Cronkite" of Clinical Decision Support?

Walter Cronkite, who anchored the CBS Evening News from 1962 to 1981, was named “the most trusted man in America” in a 1972 poll. Not the most trusted news reporter or the most trusted person on television: the most trusted man in America.

Sadly, Americans’ trust in the news is currently at its lowest level in history; a recent Gallup poll found that only 28 percent of adults in the U.S. trust the news.

A recent Pew Research Center analysis noted that people, “make clear distinctions between factual reporting and personal opinion, further emphasizing an idea of news as ‘just the facts.’” Trust is important with respect to so much of what we do every day. Without trust, we would never fly in a plane, put money in a bank, or eat in a restaurant… and we would certainly never take advice from a health care provider.

As individuals and as a society, we place trust in clinicians to obtain the most trustworthy evidence and use that to inform their recommendations. We trust clinicians to make clear distinctions between facts and personal opinion, much as people expect that from high-quality news reporting. Making this distinction is not just important for the public trust, it is required to ensure patient safety. The Gallup poll found that the public is not confident in this distinction with the news, and unfortunately clinicians are increasingly finding that when they seek clinical decision support (CDS), they are often presented with opinion even when inconsistent with expert-vetted evidence, sometimes with paid advertisement for the very medication recommended in a CDS response!

Perhaps the next Gallup survey will ask if Americans believe their health care provider is using the most trustworthy CDS tool… or better yet, “What’s the ‘Walter Cronkite’ of Clinical Decision Support?”

Roy Ziegelstein, MD, MACP
Editor in Chief, DynaMed
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