title: Computer-based diagnostic expert systems in rheumatology: where do we stand in 2014?
abstract: Background. The early detection of rheumatic diseases and the treatment to target have become of utmost importance to control the disease and improve its prognosis. However, establishing a diagnosis in early stages is challenging as many diseases initially present with similar symptoms and signs. Expert systems are computer programs designed to support the human decision making and have been developed in almost every field of medicine. Methods. This review focuses on the developments in the field of rheumatology to give a comprehensive insight. Medline, Embase, and Cochrane Library were searched. Results. Reports of 25 expert systems with different design and field of application were found. The performance of 19 of the identified expert systems was evaluated. The proportion of correctly diagnosed cases was between 43.1 and 99.9%. Sensitivity and specificity ranged from 62 to 100 and 88 to 98%, respectively. Conclusions. Promising diagnostic expert systems with moderate to excellent performance were identified. The validation process was in general underappreciated. None of the systems, however, seemed to have succeeded in daily practice. This review identifies optimal characteristics to increase the survival rate of expert systems and may serve as valuable information for future developments in the field.
authors.affiliation: Department of Rheumatology, University Hospital Zurich, Gloriastrasse 25, 8091 Zurich, Switzerland.
authors.forename: Hannes
authors.initials: H
authors.lastname: Alder
authors.affiliation: Department of Rheumatology, University Hospital Zurich, Gloriastrasse 25, 8091 Zurich, Switzerland.
authors.forename: Beat A
authors.initials: BA
authors.lastname: Michel
authors.affiliation: Department of Rheumatology, Bethesda Hospital, Gellertstrasse 144, 4020 Basel, Switzerland.
authors.forename: Christian
authors.initials: C
authors.lastname: Marx
authors.affiliation: Department of Rheumatology, Bethesda Hospital, Gellertstrasse 144, 4020 Basel, Switzerland.
authors.forename: Giorgio
authors.initials: G
authors.lastname: Tamborrini
authors.affiliation: Department of Rheumatology, Zuger Kantonsspital, Landhausstrasse 11, 6340 Baar, Switzerland.
authors.forename: Thomas
authors.initials: T
authors.lastname: Langenegger
authors.affiliation: Department of Rheumatology, University Hospital Zurich, Gloriastrasse 25, 8091 Zurich, Switzerland.
authors.forename: Pius
authors.initials: P
authors.lastname: Bruehlmann
authors.affiliation: Horten Centre for Patient Oriented Research and Knowledge Transfer, University of Zurich, Pestalozzistraße 24, 8091 Zurich, Switzerland.
authors.forename: Johann
authors.initials: J
authors.lastname: Steurer
authors.affiliation: Department of Rheumatology, University Hospital Zurich, Gloriastrasse 25, 8091 Zurich, Switzerland.
authors.forename: Lukas M
authors.initials: LM
authors.lastname: Wildi
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