A prospective evaluation of the medical consultation system CADIAG-II/RHEUMA in a rheumatological outpatient clinic.
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.
Leitich
H
H
Department of Medical Computer Sciences, Setion of Medical Expert and Knowledge-Based Systems University of Vienna Medical School, Austria. harald.leitich@univie.ac.at
Kiener
H P
HP
Kolarz
G
G
Schuh
C
C
Graninger
W
W
Adlassnig
K P
KP
D001317:Austria; D003936:Diagnosis, Computer-Assisted; D005103:Expert Systems; D017143:Fuzzy Logic; D006801:Humans; D012216:Rheumatic Diseases / Q000175:diagnosis*; D012680:Sensitivity and Specificity