Tanaka T, Miwa K, Kanda S
Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, Kyushu University, Fukuoka, Japan.
Dentomaxillofac Radiol. 1997 Mar;26(2):125-31. doi: 10.1038/sj.dmfr.4600225.
To apply fuzzy reasoning in a computer-assisted diagnostic system for ultrasonography and to evaluate its clinical utility as a diagnostic aid for the unskilled clinician.
A computer-assisted diagnostic system for ultrasonography was constructed to differentiate metastatic from inflammatory lymph nodes. The pattern of a skilled clinician's considerations was simulated with the fuzzy expert system. Three fuzzy production rules were set up according to the diagnostic criteria for lymphadenopathy. Each rule was transformed into a membership function. The max-min composition method was used for inference and the centroid method for defuzzification. The system was tested with 20 clinicians who were one to three years after graduation and inexperienced in ultrasonography. Accuracy, sensitivity and specificity were evaluated.
The average increase in accuracy was 8.5%, and the sensitivity and specificity 10.7% and 6.4% respectively. These scores were significant for accuracy (P = 0.005), sensitivity (P = 0.02) and specificity (P = 0.036).
Application of fuzzy reasoning in an expert system for ultrasonography improves the diagnostic performance of inexperienced clinicians.
将模糊推理应用于超声计算机辅助诊断系统，并评估其作为非专业临床医生诊断辅助工具的临床效用。
构建一个用于区分转移性淋巴结和炎性淋巴结的超声计算机辅助诊断系统。用模糊专家系统模拟熟练临床医生的思考模式。根据淋巴结病的诊断标准建立了三条模糊产生式规则。每条规则都转化为一个隶属函数。采用最大-最小合成法进行推理，采用重心法进行去模糊化。该系统对20名毕业后1至3年且无超声检查经验的临床医生进行了测试。评估了准确性、敏感性和特异性。
准确性平均提高8.5%，敏感性和特异性分别提高10.7%和6.4%。这些分数在准确性（P = 0.005）、敏感性（P = 0.02）和特异性（P = 0.036）方面具有统计学意义。
在超声专家系统中应用模糊推理可提高非专业临床医生的诊断性能。
