De Dombal F T, Leaper D J, Horrocks J C, Staniland J R, McCann A P
Br Med J. 1974 Mar 2;1(5904):376-80. doi: 10.1136/bmj.1.5904.376.
This paper reports a controlled trial of human and computer-aided diagnosis in a series of 552 patients with acute abdominal pain. The overall diagnostic accuracy of the computer-aided system was 91.5% and that of the senior clinician to see each case was 81.2%. However, the clinician's diagnostic performance improved markedly during the period of the trial. The proportion of appendices which perforated before operation fell from 36% to 4% during the trial, and the negative laparotomy rate dropped sharply. After the trial closed in August 1972 these figures reverted towards their pretrial levels.It is suggested that while computer-aided diagnosis is a valuable direct adjunct to the clinician dealing with the "acute abdomen," he may also benefit in the short-term from the constant feedback he receives and from the disciplines and constraints involved in communicating with the computer.
本文报告了一项针对552例急性腹痛患者的人机辅助诊断对照试验。计算机辅助系统的总体诊断准确率为91.5%,而每位病例由资深临床医生诊断的准确率为81.2%。然而,在试验期间临床医生的诊断表现有显著改善。试验期间,术前发生穿孔的阑尾比例从36%降至4%,阴性剖腹率也大幅下降。1972年8月试验结束后,这些数据又恢复到试验前的水平。有人认为,虽然计算机辅助诊断是临床医生处理“急腹症”的一项有价值的直接辅助手段,但临床医生在短期内也可能受益于他所获得的持续反馈,以及与计算机交流所涉及的规范和限制。