A computer program for the diagnosis of hematologic disorders

Abstract

A computer program has been developed to assist medical personnel in the diagnosis of hematologic disorders. The program requests information such as the patient's hematocrit, white blood‐cell count, platelet count, and selected physical findings. Major problems are identified, and the program then requests further information as needed to determine whether the patient has 1 or more of 174 hematologic disorders. An evaluation note is then printed that summarizes the most important hematologic data and includes a list of selected hematologic diagnoses, a discussion of why each diagnosis is listed, a description of its pathophysiology and information concerning etiology and treatment. The printout concludes with pertinent references to the medical literature. When the program was tested with 135 patients referred for hematologic consultation, diagnoses produced by the program were in complete agreement with the hematologist in 87 cases, in partial agreement in 23 cases and not in agreement in 25 cases. The program was also tested with 34 hematologic cases from the New England Journal of Medicine's Clinical‐Pathological Conferences. In 24 patients, the computer and anatomic diagnoses were in complete or partial agreement, and in 10 they disagreed. Anecdotal evidence suggests that explanations of pathophysiology contained in the evaluation notes may be useful to students. It is concluded that the program could be useful as a memory aid for the practitioner and as a teaching aid for the student.