Leitich H, Kiener H P, Kolarz G, Schuh C, Graninger W, Adlassnig K P
Department of Medical Computer Sciences, Setion of Medical Expert and Knowledge-Based Systems University of Vienna Medical School, Austria.
Methods Inf Med. 2001 Jul;40(3):213-20.
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.
为评估CADIAG-II/RHEUMA在风湿科门诊患者初诊中作为诊断辅助工具的性能，我们对54例患者进行了CADIAG-II/RHEUMA诊断咨询，并将生成的诊断假设列表与每个临床出院诊断进行比较。在总共126个风湿科出院诊断中，有26个没有匹配的CADIAG-II/RHEUMA诊断。在所有其他出院诊断中，94%出现在CADIAG-II/RHEUMA假设列表中，82%出现在假设列表的前三分之一中，48%出现在前五个假设中。我们确定了以下限制CADIAG-II/RHEUMA生成全面且正确排序的诊断假设列表能力的因素：（1）很大比例的患者处于未明确诊断的风湿性疾病早期阶段；（2）与大量已知风湿性疾病相比，CADIAG-II/RHEUMA诊断数量有限；（3）风湿性疾病很少由单一特征性表现来定义，通常是通过多种非特异性表现的组合来诊断。
