Strengths and weaknesses of direct patient interviewing by a microcomputer system in specialist gynaecological practice.

An inexpensive microcomputer system has been used to obtain histories in the gynaecological clinic. Initially, this system was applied to infertility/endocrine patients, but the programs were subsequently expanded to deal with a wide range of presenting symptoms. Questions are displayed on a visual display unit and the patient enters her answers on a simplified keypad. A formatted summary is provided by an interfaced printer. Cross-over comparison with manual histories showed that the computer produces an accurate and exhaustive record containing many additional items. This improvement was most marked for the infertility/endocrine system, where the computer provided 2.9-times as much information as a clinician. In the case of the general gynaecological history the computer obtained 1.6-times as much information. Both systems showed a high degree of consumer acceptance. This was more marked in the case of the specialist application: 77.5% of infertility/endocrine patients felt that the questionnaire had adequately covered their problem, compared to 44.5% of general gynaecological patients. Over-reporting of apparently trivial symptoms was more marked in the general system. Thus, we conclude that direct patient-interviewing systems can be recommended for relatively complex specialist applications, such as infertility/endocrinology. They may be less suitable for general applications such as gynaecology as a whole.