title: Computer-assisted diagnosis of abdominal pain using "estimates" provided by clinicians.
abstract: This paper reports a comparison between two modes of computer-aided diagnosis in a real-time prospective trial involving 472 patients with acute abdominal pain. In the first mode the computer-aided system analysed each of the 472 patients by referring to data previously collated from a large series of 600 real-life patients. In the second mode the system used as a basis for its analysis "estimates" of probability provided by a group of six clinicians. The accuracy and reliability of both modes were compared with the performance of unaided clinicians.Using "real-life" data the computer system was significantly more effective than the unaided clinician. By contrast, when using the clinicians' own estimates the computer-aided system was often less effective than the unaided clinician-especially when diagnosing less common disorders. It seems, firstly, that future systems for computer-aided diagnosis should employ data from real-life and not clinicians' estimates, and, secondly, that clinicians themselves cannot analyse cases in a probabilistic fashion, since often they have little idea of what the "true" probabilities are.
mesh_terms: D000006:Abdomen, Acute / Q000175:diagnosis* / Q000453:epidemiology; D001064:Appendicitis / Q000175:diagnosis; D002764:Cholecystitis / Q000175:diagnosis; D003936:Diagnosis, Computer-Assisted; D003937:Diagnosis, Differential; D003951:Diagnostic Errors; D004240:Diverticulum / Q000175:diagnosis; D004381:Duodenal Ulcer / Q000175:diagnosis; D006801:Humans; D007415:Intestinal Obstruction / Q000175:diagnosis; D010195:Pancreatitis / Q000175:diagnosis; D011336:Probability