title: A technique for analyzing clinical data to provide patient management guidelines.
abstract: This article describes a technique for analyzing clinical data in order to guide patient management decisions. The technique is illustrated by considering a specific decision problem encountered in the management of possible meningitis, namely, whether or not to administer antibiotics while awaiting the results of a CSF bacterial culture. Data from 303 patients with meningitis are analyzed in order to determine which combination of clinical variables best discriminates between bacterial and aseptic cases. From these variables, a probability tree is constructed that indicates the probability of bacterial meningitis, depending on a patient's clinical characteristics. In addition to identifying the most important variables, the analysis reveals that a number of tests performed routinely on patients with meningitis are of questionable diagnostic value.
mesh_terms: D001424:Bacterial Infections / Q000175:diagnosis* / Q000628:therapy; D002648:Child; D003657:Decision Making; D003936:Diagnosis, Computer-Assisted; D006801:Humans; D008581:Meningitis / Q000175:diagnosis* / Q000628:therapy; D008962:Models, Theoretical; D011336:Probability; D012189:Retrospective Studies