Use of computer program for diagnosing jaundice in district hospitals and specialized liver unit.
A computer-assisted model for diagnosing jaundice has been adapted for use on the University of London C.D.C. 7600 computer via an on-line terminal at King's College Hospital to provide a rapid turn-round time. The model was used prospectively in the diagnosis of 219 patients--135 seen in a specialized liver unit and 84 seen in one of four district hospitals in south-east London--with an overall accuracy in distinguishing among 11 different causes of jaundice of 69% and 62% respectively. These figures rose to 77% and 88% respectively when only those patients in whom the final diagnosis reached a "certain" probability were considered. When used to distinguish between a medical and a surgical cause of jaundice the accuracy was 86% in the liver unit and 77% in the district hospitals, rising to 95% in both series for those with a diagnosis of certain probability. The proposed improvements to the model--namely, the use of two deparate data bases and more diagnoses within the matrix--should be improve the accuracy even further. In practice the rapid feedback to the clinicians looking after patients provided help in managing difficult cases.
D001650:Bile Duct Neoplasms / Q000175:diagnosis; D056486:Chemical and Drug Induced Liver Injury / Q000175:diagnosis; D002769:Cholelithiasis / Q000175:diagnosis; D002779:Cholestasis / Q000175:diagnosis; D003936:Diagnosis, Computer-Assisted; D003937:Diagnosis, Differential; D005246:Feedback; D006505:Hepatitis / Q000175:diagnosis; D006748:Hospital Departments; D006801:Humans; D007565:Jaundice / Q000175:diagnosis* / Q000209:etiology; D008103:Liver Cirrhosis / Q000175:diagnosis; D008105:Liver Cirrhosis, Biliary / Q000175:diagnosis; D008107:Liver Diseases / Q000175:diagnosis; D008131:London; D008954:Models, Biological; D009362:Neoplasm Metastasis / Q000175:diagnosis; D011336:Probability