do Amaral M B, Satomura Y, Honda M, Sato T
Division of Medical Informatics, Chiba University Hospital, Japan.
Methods Inf Med. 1995 Jun;34(3):232-43.
We describe a diagnostic support system for clinical psychiatry and its evaluation results. The system has two inter-related components: a rule-based reasoning part associated with uncertainty, and a deterministic part, that uses heuristics to perform categorical reasoning. The system includes the 30 groups of psychiatric diagnoses which are classified under the categories 290 to 319 of the DSM-III-R and the ICD-9. There are, in fact, 1508 rules relating 208 clinical findings with 257 diagnoses. The reasoning strategy is based on selecting and differentiating diagnostic categories in a hierarchical classification tree. The system is intended to be used for education of medical students, and to help non-specialist clinicians, residents in psychiatry, or experts with few years of experience in decision making. We tested the diagnostic performance of the system using case reports extracted from a specialized journal. In 52.8% of the cases, the correct diagnosis was ranked as the first hypothesis using only the rule-based part. In combination with the deterministic strategy, the correct diagnosis could be made for 73.6% of the analyzed cases.
我们描述了一种用于临床精神病学的诊断支持系统及其评估结果。该系统有两个相互关联的部分：一个与不确定性相关的基于规则的推理部分，以及一个使用启发式方法进行分类推理的确定性部分。该系统包括根据《精神疾病诊断与统计手册》第三版修订版（DSM-III-R）和《国际疾病分类》第九版（ICD-9）的290至319类别分类的30组精神疾病诊断。实际上，有1508条规则将208项临床发现与257种诊断相关联。推理策略基于在分层分类树中选择和区分诊断类别。该系统旨在用于医学生的教育，并帮助非专科临床医生、精神病学住院医生或经验较少的专家进行决策。我们使用从专业期刊中提取的病例报告测试了该系统的诊断性能。在52.8%的病例中，仅使用基于规则的部分时，正确诊断被列为首要假设。结合确定性策略，对于73.6%的分析病例可以做出正确诊断。
