[Usefulness of computers in diagnosis and therapy. The principle of the privileged hypothesis. The example of glaucoma].
OBJECTIVE
Everyone sees only the errors of others, for diagnosis error proves difficult to detect inasmuch as medical reasoning is complex and subject to little supervision.


METHODS
In the semiologic phase of everyday diagnosis, any sign can be overlooked: error by omission, or be poorly analyzed: error by confusion. Putting forward hypotheses based on observation is hazardous whenever data is used following the tenet that "these signs call up this disease," which is the opposite of "in this disease, these signs often or sometimes occur." Moreover, a comprehensive and detailed memorization is essential in order to avoid errors of omission: a hypothesis has been forgotten; or of confusion: a disease has been poorly memorized.


METHODS
However vast it may be, the volume of data describing the miscellaneous pictures of glaucoma is finite and therefore usable on well-known computer devices. The nearly 1,000 pictures, Ma, Mb, etc., are described by 85 signs, sa, sb, etc. These signs are standard, objective, semiologically accurate, and independent. They are logically equivalent because the value of a given sign, of greater or lesser importance, only appears after the diagnosis has been ascertained. The pathological condition is exhibited as a set of enunciations: Ma=sa, sb, sc, etc.


RESULTS
Written in Visual Basic, the program described herein runs on a basic PC workstation. The selection of predicates incorporating the signs of clinical observation suggests the likely diagnoses; probability calculus determines the favored hypothesis and its reliability. The etiological and differential diagnoses relying on one, two or three signs are outlined, as are therapies and contraindications. This information is comprehensive, detailed, pertinent, and updated.
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D000465:Algorithms; D003936:Diagnosis, Computer-Assisted; D003951:Diagnostic Errors; D005901:Glaucoma / Q000145:classification / Q000175:diagnosis* / Q000628:therapy; D006801:Humans; D008838:Microcomputers; D012984:Software; D013813:Therapy, Computer-Assisted