Computer-aided diagnosis: A review

Abstract

Fifteen years ago, computer-aided diagnosis of the acute abdomen promised much. Today it is little used. Studies have been flowed by poor trial design, bias, selective reporting of results, statistical naivety and spurious conclusions. The computer system lacks 'common sense' and is less accurate than clinicians. Yet its introduction has been associated with improved patient management and outcome. Much of the effect arises from structured data collection methods and some from audit feedback to clinicians. It is on these innovations, not on the computer, that future work should focus.

Idiot's Bayes: Not So Stupid after All?

“…Interestingly, however, 'for all sets of variables and all performance criteria, Independence Bayes with a global association factor produced the most reliable predictions'. Sutton (1989) presented a critical review of computer-aided diagnosis of acute abdominal problems. He concluded that much of the improved patient management and outcome effects are due to the structured data collection methods and feedback which are a part of such investigations, rather than the automated diagnostic methods themselves (see also Wellwood & Spiegelhalter, 1989;Paterson-Brown et al, 1989;Gunn, 1991), and he pointed out many of the weaknesses of the early studies.…”

“…Clearly, depending on the number of raw variables and the relationships between them, this may lead to superior performance. In a similar vein,Crichton & Hinde (1988, 1989 used correspondence analysis to help to choose which variables, from a large potential set, should be included in an independence Bayes model. They went on to compare this approach with CART on a chest pain data set, finding that the independence Bayes model yielded superior performance.…”

A software engineering approach to the design of a medical expert system

“…The most frequently used method is to apply Bayes theorem with the assumption of conditional independence [l]. Unfortunately, it has not yet been clearly established that computer programs are sufficiently accurate that they are capable of providing practical decision support in this area [12]. Other approaches are therefore worth exploring, including those employing background medical knowledge.…”

A decision-making learning and assessment tool in laparoscopic cholecystectomy

“…While decision making has been studied in depth in high-risk industries such as aviation, the importance of this skill is being increasingly recognised by surgeons, hence the value in finding new and better ways of teaching trainees how to make accurate intraoperative decisions [11][12][13][14][15][16][17][18][19][20][21][22][23][24][25][26][27][28][29][30].…”