Knowledge based lipid management system for general practitioners

Sinnott, Margaret; Carr, Bernadette; Markey, Jennifer; Brosnan, P.; Boran, G.; Grimson, Jane; McGill, Tony; Feely, J.; O’Moore, R. R.

doi:10.1016/0009-8981(93)90093-j

Cited by 6 publications

(3 citation statements)

References 6 publications

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“…Others have developed a "to do" list to remind and alert treating physicians about tests they should order, based on input into electronic patient records [30]. In the narrow area of managing lipid levels, there was a 93% agreement between management advice given by the expert system, and the specialist, after interpretation of laboratory and clinical data [31]. However, physicians have a 65% level of accepting comments from expert systems regarding diagnosis of a patient, and are resistant to comments about prescriptions for patients, with only a 35% acceptance level [32].…”

Section: Discussionmentioning

confidence: 99%

Diagnoses from an On-Line Expert System for Chronic Pain Confirmed by IntraOperative Findings

2016

JAPM

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A number of researchers from Johns Hopkins Hospital report that 40%-80% of chronic pain patients are misdiagnosed. Previous reports indicate an on-line questionnaire, The Diagnostic Paradigm and Treatment Algorithm, provides diagnoses with a 96.3% correlation with diagnoses of Johns Hopkins Hospital staff members, in patients with chronic back, neck or limb pain. This research was undertaken to determine if diagnoses generated by the Diagnostic Paradigm and Treatment Algorithm could be confirmed by irrefutable indications of pathology, i.e. intra-operative findings. Prior to surgery, the Diagnostic Paradigm and Treatment Algorithm was administered to ten patients. The Diagnostic Paradigm predicted 61/61 (100%) diagnoses which were confirmed intra-operatively. The Diagnostic Paradigm had 71 false positive diagnoses, but these were part of the differential diagnoses of the correct diagnoses. These differential diagnoses were refined by medical testing.

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Section: Discussionmentioning

confidence: 99%

Diagnoses from an On-Line Expert System for Chronic Pain Confirmed by IntraOperative Findings

2016

JAPM

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“…Rulebased or knowledge-based systems have been designed for many, but nearly always specific, clinical and laboratory problems (32 ), including endocrinology (33 ), diagnosis of hepatitis and lipid disorders (34,35 ), test ordering (36 ), validation of biochemical data (37)(38)(39)(40), interpretation of electrophoresis patterns (41 ), or interpretation of urinary proteins patterns (7,42 ). A more comprehensive endeavor has been the development of commercially available computer-based diagnostic systems for general medicine (43)(44)(45)(46).…”

Section: Discussionmentioning

confidence: 99%

Windows to the Ward: Graphically Oriented Report Forms. Presentation of Complex, Interrelated Laboratory Data for Electrophoresis/Immunofixation, Cerebrospinal Fluid, and Urinary Protein Profiles

Regeniter¹,

Steiger

Scholer³

et al. 2003

Clinical Chemistry

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Background: Automated laboratory analyzers that mass produce data have been linked to information systems for more than two decades, but little progress has been made in developing more comprehensible report forms. Results are still reported in computer-generated printouts containing hundreds of numbers crowded into columns on each printed page. Methods: We developed three software applications focusing on the graphic presentation of laboratory results. Results: The first application summarizes data for a patient with a monoclonal gammopathy. The report provides a cumulative graphic presentation of immunofixation/electrophoresis data without any additional interpretation, focuses on a color-coded electrophoresis scan, and records up to 5 years on a single page. The second application deals with cerebrospinal fluid analysis. The report calculates relevant data and graphs the complex relationship between albumin and immunoglobulin results from paired serum and cerebrospinal fluid samples. Manually added interpretive text assures an output comprehensible to clinicians in all specialties. The third application produces a report summarizing quantitatively measured urinary marker protein profiles. The report form is generated by a flexible, completely user-definable knowledge-based system. It calculates numerous ratios and formulae, supports reflex testing, supplies an automated interpretation, and generates a specific graphic signature pattern of the results (MDI LabLink proteinuria differentiation). Conclusions: Increased clinical demand for graphically oriented report forms 5 years after their introduction has provided evidence that these reports transfer complex laboratory data and results to the clinician more effectively. The highest (more than threefold) increase in demand has been for reports for urinary marker protein profiles that feature a largely self-explanatory graphic signature pattern.

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“…Others have developed a "to do" list to remind and alert treating physicians about tests they should order, based on input into electronic patient records [29]. In the narrow area of managing lipid levels, there was a 93% agreement between management advice given by the expert system, and the specialist, after interpretation of laboratory and clinical data [30]. However, physicians have a 65% level of accepting comments from expert systems regarding diagnosis of a patient, and are resistant to comments about prescriptions for patients, with only a 35% acceptance level [31].…”

Section: Discussionmentioning

confidence: 99%

Comparison of Clinical Diagnoses Versus Computerized Test Diagnoses using the Maryland Clinical Diagnostics Diagnostic Paradigm (Expert System) for Diagnosing Chronic Pain in the Neck, Back and Limbs

Hendler¹,

Spurgeon²

2016

JACCOA

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Past research found that 40%-71% of chronic pain patients had overlooked diagnoses, underscoring the need for more accurate diagnostic methodology. In this study, 28 diagnoses were made by the senior author during the initial evaluation of 5 chronic pain patients. Of these diagnoses, 27 diagnoses made by the senior author were also made by the computer scored and interpreted Maryland Clinical Diagnostics (MCD) "Diagnostic Paradigm." The MCD Diagnostic Paradigm matched the senior author's evaluation 96.37 % of the time, and the Diagnostic Paradigm missed 1 diagnoses made by the senior author, for a 3.63% "missed diagnosis" rate, based on the initial clinic evaluation.Overall there were 4 "Test Only Positives," i.e. diagnoses made by the Diagnostic Paradigm, but not made by the senior author. Therefore, these patients received the benefit of additional diagnostics studies, which helped the chiropractor obtain an additional diagnoses 16% of the time, which he otherwise might have overlooked, as the results of the "Test Only Positive" diagnosis.The Pain Validity Test could predict which of the patients would have moderate or severe abnormalities on objective medical tests with 100% accuracy. The Diagnostic Paradigm predicted the specific abnormality on objective medical testing with 98% accuracy.

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Knowledge based lipid management system for general practitioners

Cited by 6 publications

References 6 publications

Diagnoses from an On-Line Expert System for Chronic Pain Confirmed by IntraOperative Findings

Diagnoses from an On-Line Expert System for Chronic Pain Confirmed by IntraOperative Findings

Windows to the Ward: Graphically Oriented Report Forms. Presentation of Complex, Interrelated Laboratory Data for Electrophoresis/Immunofixation, Cerebrospinal Fluid, and Urinary Protein Profiles

Comparison of Clinical Diagnoses Versus Computerized Test Diagnoses using the Maryland Clinical Diagnostics Diagnostic Paradigm (Expert System) for Diagnosing Chronic Pain in the Neck, Back and Limbs

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