Potter B, Ronan S G
Department of Dermatology, Medical Group of Michigan City Professional Corporation, Indiana.
J Fam Pract. 1990 Feb;30(2):201-10.
A transferable computer program for the differential diagnosis of diseases of the skin, CLINDERM, has been produced for use by physicians on standard IBM and compatible personal microcomputers. This program lists the differential diagnosis and definitive diagnosis of any presented disease of the skin, except single tumors. The physician operator indicates the distribution and detailed description of lesions, which the interactive system integrates with a comprehensive knowledge base. The computer diagnosis in 129 cases was compared with independent interpretation of the same information by an academic dermatologist. Results were synonymous in 66.7% of all diseases and similar in an additional 4.7%. A common differential diagnosis was obtained in 24%, for a 95.3% rate of synonymous, similar, or common differential diagnoses. Diagnosis was different in 3.9% and description was inadequate for diagnosis in 0.8%. The variation in diagnosis showed that some descriptive terms are prejudicial of certain diagnoses; that diagnostic terms are not all completely standardized; that some diagnoses are variants of another disease; and that drug-induced eruptions simulate many other diseases. A skin disease can usually be diagnosed by specific description. Most lesions that are not diagnostic from inspection are nodular. A computer can be programmed to list diagnoses according to morphologic description.
已开发出一种用于皮肤疾病鉴别诊断的可移植计算机程序CLINDERM，供医生在标准IBM及兼容个人微型计算机上使用。该程序列出了除单发肿瘤外任何呈现的皮肤疾病的鉴别诊断和确诊诊断。医生操作员指出病变的分布和详细描述，交互系统将这些信息与综合知识库进行整合。将129例病例的计算机诊断结果与一位皮肤科专家对相同信息的独立解读进行了比较。在所有疾病中，66.7%的结果是一致的，另有4.7%的结果相似。24%的病例获得了共同的鉴别诊断，同义、相似或共同鉴别诊断的比例为95.3%。诊断结果不同的占3.9%，描述不足以进行诊断的占0.8%。诊断结果的差异表明，一些描述性术语对某些诊断有偏见；诊断术语并非全部完全标准化；一些诊断是另一种疾病的变体；药物性皮疹可模拟许多其他疾病。通常可以通过具体描述来诊断皮肤病。大多数通过检查无法诊断的病变是结节状的。可以对计算机进行编程，使其根据形态学描述列出诊断结果。
