title: A prospective evaluation of the medical consultation system CADIAG-II/RHEUMA in a rheumatological outpatient clinic.
abstract: To evaluate the performance of CADIAG-II/RHEUMA as consultant in the primary evaluation of patients visiting a rheumatological outpatient clinic, a CADIAG-II/RHEUMA consultation was done for 54 patients and the list of generated diagnostic hypotheses was compared to each clinical discharge diagnosis. For 26 of a total of 126 rheumatological discharge diagnoses, no matching CADIAG-II/RHEUMA diagnosis was available. 94% of all other discharge diagnoses were found in the list of CADIAG-II/RHEUMA hypotheses, 82% among the first third of the list of hypotheses and 48% among the first five hypotheses. We identified the following factors limiting the ability of CADIAG-II/RHEUMA to generate a comprehensive and correctly ranked list of diagnostic hypotheses: (1) a large percentage of patients with early stages of not clearly identified rheumatological conditions; (2) the limited number of CADIAG-II/RHEUMA diagnoses compared to the large number of known rheumatological conditions; (3) the fact that rheumatological diseases are rarely characterized by a single pathognomonic feature but are usually diagnosed by combinations of rather unspecific findings.
authors.affiliation: Department of Medical Computer Sciences, Setion of Medical Expert and Knowledge-Based Systems University of Vienna Medical School, Austria. harald.leitich@univie.ac.at
authors.forename: H
authors.initials: H
authors.lastname: Leitich
authors.forename: H P
authors.initials: HP
authors.lastname: Kiener
authors.forename: G
authors.initials: G
authors.lastname: Kolarz
authors.forename: C
authors.initials: C
authors.lastname: Schuh
authors.forename: W
authors.initials: W
authors.lastname: Graninger
authors.forename: K P
authors.initials: KP
authors.lastname: Adlassnig
mesh_terms: D001317:Austria; D003936:Diagnosis, Computer-Assisted; D005103:Expert Systems; D017143:Fuzzy Logic; D006801:Humans; D012216:Rheumatic Diseases / Q000175:diagnosis*; D012680:Sensitivity and Specificity