title: The Diagnostic Value of Skin Disease Diagnosis Expert System.
abstract: BACKGROUND
  Evaluation is a necessary measure to ensure the effectiveness and efficiency of all systems, including expert systems. The aim of this study was to determine the diagnostic value of expert system for diagnosis of complex skin diseases.
  
  
  METHODS
  A case-control study was conducted in 2015 to determine the diagnostic value of an expert system. The study population included patients who were referred to Razi Specialized Hospital, affiliated to Tehran University of Medical Sciences. The control group was selected from patients without the selected skin diseases. Data collection tool was a checklist of clinical signs of diseases including pemphigus vulgaris, lichen planus, basal cell carcinoma, melanoma, and scabies. The sample size formula estimated 400 patients with skin diseases selected by experts and 200 patients without the selected skin diseases. Patient selection was undertaken with randomized stratified sampling and their sign and symptoms were logged into the system. Physician's diagnosis was determined as the gold standard and was compared with the diagnosis of expert system by SPSS software version 16 and STATA. Kappa statistics, indicators of sensitivity, specificity, accuracy and confidence intervals were calculated for each disease. An accuracy of 90% was considered appropriate.
  
  
  RESULTS
  Comparing the results of expert system and physician's diagnosis at the evaluation stage showed an accuracy of 97.1%, sensitivity of 97.5% and specificity of 96.5% The Kappa test indicated a high agreement of 93.6%.
  
  
  CONCLUSIONS
  The expert system can diagnose complex skin diseases. Development of such systems is recommended to identify all skin diseases.
authors.affiliation: Health Information Management Research Center, Kashan University of Medical Scienves, Kashan Iran.
authors.forename: Fatemeh Rangraz
authors.initials: FR
authors.lastname: Jeddi
authors.affiliation: Department of Bioinformatics, Tehran University, Kish International Campus, Kish, Iran.
authors.forename: Masoud
authors.initials: M
authors.lastname: Arabfard
authors.affiliation: Health Information Management Research Center, Kashan University of Medical Scienves, Kashan Iran.
authors.forename: Zahra
authors.initials: Z
authors.lastname: Arabkermany
authors.affiliation: Health Information Management Research Center, Kashan University of Medical Scienves, Kashan Iran.
authors.forename: Hamidreza
authors.initials: H
authors.lastname: Gilasi
keywords: Diagnostic value; Disease; Evaluation; Expert System; Skin