title: Decision support system for the diagnosis of schizophrenia disorders.
abstract: Clinical decision support systems are useful tools for assisting physicians to diagnose complex illnesses. Schizophrenia is a complex, heterogeneous and incapacitating mental disorder that should be detected as early as possible to avoid a most serious outcome. These artificial intelligence systems might be useful in the early detection of schizophrenia disorder. The objective of the present study was to describe the development of such a clinical decision support system for the diagnosis of schizophrenia spectrum disorders (SADDESQ). The development of this system is described in four stages: knowledge acquisition, knowledge organization, the development of a computer-assisted model, and the evaluation of the system's performance. The knowledge was extracted from an expert through open interviews. These interviews aimed to explore the expert's diagnostic decision-making process for the diagnosis of schizophrenia. A graph methodology was employed to identify the elements involved in the reasoning process. Knowledge was first organized and modeled by means of algorithms and then transferred to a computational model created by the covering approach. The performance assessment involved the comparison of the diagnoses of 38 clinical vignettes between an expert and the SADDESQ. The results showed a relatively low rate of misclassification (18-34%) and a good performance by SADDESQ in the diagnosis of schizophrenia, with an accuracy of 66-82%. The accuracy was higher when schizophreniform disorder was considered as the presence of schizophrenia disorder. Although these results are preliminary, the SADDESQ has exhibited a satisfactory performance, which needs to be further evaluated within a clinical setting.
authors.affiliation: Departamento de Psiquiatria, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, SP, Brazil. razzouk@psiquiatria.epm.br
authors.forename: D
authors.initials: D
authors.lastname: Razzouk
authors.forename: J J
authors.initials: JJ
authors.lastname: Mari
authors.forename: I
authors.initials: I
authors.lastname: Shirakawa
authors.forename: J
authors.initials: J
authors.lastname: Wainer
authors.forename: D
authors.initials: D
authors.lastname: Sigulem
mesh_terms: D020000:Decision Support Systems, Clinical; D003936:Diagnosis, Computer-Assisted / Q000295:instrumentation*; D005103:Expert Systems; D006801:Humans; D015203:Reproducibility of Results; D012559:Schizophrenia / Q000175:diagnosis*