Lawrence P C, Clifford P C, Taylor I F
Southampton General Hospital.
Ann R Coll Surg Engl. 1987 Sep;69(5):233-4.
This report explores the role of computer aided diagnosis in acute abdominal pain when applied by non-medically qualified personnel. Clinical features of 153 patients (75 males, 78 females, aged range 6-92 years, median 35 years) suffering from less than one weeks' abdominal pain were recorded. Junior doctors' diagnostic accuracy with (65 cases) and without (70 cases) structured computer history sheets were compared with first year clinical medical students using the computer system (46 cases: 28 also seen by doctor, 18 cases student only). These students had no previous surgical training or experience. Doctors' diagnostic accuracy of 51% rose significantly to 69% with the use of structured history forms (chi 2 = 4.53, P = less than 0.05). Computer assisted clinical students' diagnostic accuracy matched the improved doctors' accuracy (69.5%). These results have implications not only for medical education but also for isolated paramedical personnel who should be supplied with structured diagnostic forms and, where appropriate, a microcomputer.
本报告探讨了非医学专业人员应用计算机辅助诊断在急性腹痛中的作用。记录了153例腹痛时间少于一周的患者(75例男性,78例女性,年龄范围6 - 92岁,中位数35岁)的临床特征。比较了初级医生使用(65例)和不使用(70例)结构化计算机病史表时的诊断准确性,以及使用计算机系统的一年级临床医学学生(46例:28例也由医生看过,18例仅由学生看过)的诊断准确性。这些学生此前没有外科培训或经验。使用结构化病史表后,医生的诊断准确率从51%显著提高到69%(卡方检验χ2 = 4.53,P < 0.05)。计算机辅助临床学生的诊断准确率与提高后的医生准确率(69.5%)相当。这些结果不仅对医学教育有意义,对于独立的辅助医疗人员也有意义,应为他们提供结构化诊断表格,并在适当情况下提供微型计算机。