Bramble J M, Insana M F, Dwyer S J
Department of Diagnostic Radiology, University of Kansas Medical Center, Kansas City 66103.
J Digit Imaging. 1990 Aug;3(3):164-9. doi: 10.1007/BF03167602.
A computer algorithm for information retrieval from an electronic teaching file has been developed. This index enables the user to retrieve cases from a teaching file, based on the input of a combination of features. The algorithm is based on nearest neighbor analysis, and is programmed in the "C" language. A teaching file with this index is very easy to use as a reference resource for diagnosing unknown cases. A model was developed for a preliminary test of how likely a user would be to review a teaching file case that is the same diagnosis as an unknown case, thereby reducing uncertainty of diagnosis. The model used 110 cases of arthritis radiographs of hands scored by a skeletal radiologist. The result of the model suggests that the correct diagnosis would be reviewed 83% of the time. A standard method of reducing uncertainty of diagnosis (the maximum likelihood discriminant function) would have picked the correct diagnosis 78% of the time. The results indicate that a teaching file with the computer index is a practical tool for dealing with the uncertainty in diagnosis of unknown cases. The computer index could be included with videodisc-based teaching files (such as the American College of Radiology files). Using teaching files as a reference for interpreting unknown cases may reduce interobserver variability.
已开发出一种用于从电子教学文件中检索信息的计算机算法。该索引能让用户根据一系列特征组合的输入,从教学文件中检索病例。该算法基于最近邻分析,并采用“C”语言编程。带有此索引的教学文件作为诊断未知病例的参考资源非常易于使用。开发了一个模型,用于初步测试用户查看与未知病例诊断相同的教学文件病例的可能性,从而降低诊断的不确定性。该模型使用了由骨骼放射科医生评分的110例手部关节炎X光片病例。模型结果表明,83%的情况下能查看正确诊断。一种降低诊断不确定性的标准方法(最大似然判别函数)在78%的情况下能选出正确诊断。结果表明,带有计算机索引的教学文件是处理未知病例诊断不确定性的实用工具。计算机索引可包含在基于视频光盘的教学文件(如美国放射学会的文件)中。将教学文件用作解释未知病例的参考可能会减少观察者间的差异。