Department of General Internal Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, 100730, China.
Institute of Nuclear and New Energy Technology, Tsinghua University, Beijing, 100084, China.
Front Med. 2020 Aug;14(4):488-497. doi: 10.1007/s11684-020-0762-0. Epub 2020 Jul 16.
Dyspnea is one of the most common manifestations of patients with pulmonary disease, myocardial dysfunction, and neuromuscular disorder, among other conditions. Identifying the causes of dyspnea in clinical practice, especially for the general practitioner, remains a challenge. This pilot study aimed to develop a computer-aided tool for improving the efficiency of differential diagnosis. The disease set with dyspnea as the chief complaint was established on the basis of clinical experience and epidemiological data. Differential diagnosis approaches were established and optimized by clinical experts. The artificial intelligence (AI) diagnosis model was constructed according to the dynamic uncertain causality graph knowledge-based editor. Twenty-eight diseases and syndromes were included in the disease set. The model contained 132 variables of symptoms, signs, and serological and imaging parameters. Medical records from the electronic hospital records of Suining Central Hospital were randomly selected. A total of 202 discharged patients with dyspnea as the chief complaint were included for verification, in which the diagnoses of 195 cases were coincident with the record certified as correct. The overall diagnostic accuracy rate of the model was 96.5%. In conclusion, the diagnostic accuracy of the AI model is promising and may compensate for the limitation of medical experience.
呼吸困难是肺部疾病、心肌功能障碍和神经肌肉紊乱等多种疾病患者最常见的表现之一。在临床实践中,特别是对于全科医生来说,确定呼吸困难的原因仍然是一个挑战。本研究旨在开发一种计算机辅助工具,以提高鉴别诊断的效率。在临床经验和流行病学数据的基础上,建立了以呼吸困难为主要主诉的疾病集。通过临床专家建立和优化了鉴别诊断方法。根据基于动态不确定因果关系图的知识编辑器构建了人工智能(AI)诊断模型。疾病集中包括 28 种疾病和综合征。该模型包含 132 个症状、体征以及血清学和影像学参数变量。随机选择了遂宁市中心医院电子病历中的病历。共纳入 202 例以呼吸困难为主要主诉的出院患者进行验证,其中 195 例的诊断与记录认证的正确诊断相符。该模型的总体诊断准确率为 96.5%。总之,该 AI 模型的诊断准确性很有前景,可能弥补了医疗经验的局限性。