Twelve years' experience of computer-aided diagnosis in a district general hospital.
This paper describes experience in a modern district general hospital with a small desktop system for computer-aided diagnosis of acute abdominal pain, over a 12-year period involving 5512 cases. When compared with a baseline year (1973) in which unaided performance was monitored, during an initial study period (1974-76) the diagnostic accuracy of junior staff rose by between 10 and 15%. This higher performance level was then maintained for a decade (1976-86) despite changes in staff. The perforation rate among appendicitis cases fell from 27% to 12.5%, accompanied by a smaller fall in negative laparotomy rates. The saving in surgical bednights devoted to acute abdominal pain was approximately 15%, and the notional cost of resources saved during the first 6 years of operation was 120,000 pounds. Other hospitals have shown--in the short term--benefits similar to those obtained at Airedale District General Hospital. The long-term benefits of the system at Airedale reinforce the conclusions of the earlier short-term trials that a comparable system should probably be offered to all DGHs in the UK, not as an exercise in 'artificial intelligence' but as an effective continuing stimulus to good clinical practice.
Airedale District General Hospital, West Yorkshire.
W A
WA
McAdam
B M
BM
Brock
T
T
Armitage
P
P
Davenport
M
M
Chan
F T
FT
de Dombal
D015746:Abdominal Pain / Q000175:diagnosis* / Q000191:economics; D000208:Acute Disease; D001064:Appendicitis; D003365:Costs and Cost Analysis; D003625:Data Collection; D003936:Diagnosis, Computer-Assisted / Q000191:economics / Q000592:standards; D004739:England; D006295:Health Resources / Q000706:statistics & numerical data; D006767:Hospitals, District; D006769:Hospitals, General; D006779:Hospitals, Public; D006801:Humans; D007416:Intestinal Perforation; D007902:Length of Stay; D008838:Microcomputers; D012422:Rupture, Spontaneous