The Role of Expert Systems in Improving the Test Requesting Patterns of Clinicians

Abstract

The many strategies proposed for influencing the test requesting patterns of clinicians have had only limited success, largely because they are labour intensive and depend on motivation and commitment. Clinical protocols which have been locally agreed between laboratory staff and clinicians are potentially one of the more successful strategies, but detailed study of their application in different clinical settings has been limited by practical problems. Expert systems offer a way of implementing locally agreed protocols and, consequently, of assisting the identification, audit and refinement of laboratory testing strategies. Where these systems have been applied in specialist units they have resulted in savings in time by both clinical and laboratory staff, and an overall reduction in the number of clinical chemistry tests done within and out of hours. These systems offer promise as a method of improving laboratory utilization.

Uso adecuado del laboratorio clínico: necesidad y tendencias

“…Para facilitar el desarrollo de las mencionadas tareas, aplicación de los protocolos, revaluación y mejora, hay soluciones informáticas, un ejemplo de ellas son los sistemas expertos 38 , que actúan como una interconexión inteligente entre el clínico y el sistema de información del laboratorio, son capaces de guiar a los clínicos en el momento de realizar una petición, y combinar la información aportada por el clínico con los resultados obtenidos del laboratorio, para dar una interpretación específica o incluso pueden generar otras magnitudes que se realizarán sobre la misma muestra. Con el uso de sistemas expertos se reduce el número de determinaciones, el número de muestras recogidas, el tiempo de respuesta y los costes 39 .…”

Information management and informatics: need for a modern pathology service

“…For example, providing fully integrated electronic patient records and links to clinical decision mechanisms can support evidence-based clinical care. 9,10 Availability of IT systems meeting pathology service needs Systems required to meet fully the objectives outlined above are not yet available, as current systems were not designed to ful¢l these requirements. Planning new IT systems therefore requires a medium-to longterm approach, and in the interim pragmatic procurement decisions may be necessary to facilitate service recon¢guration.…”

Development of Knowledge-Based Systems – a Review

“…The processing elements are simple input/output devices receiving multiple inputs but producing a single output and operate unidirectionally. The feed forward back propagation (FFBP) network is perhaps the most popular architecture for practical applicaData analysis -autoverification of CBC [12], chromogenic interferents [13] Interpretation -hepatitis tests [14], pancreatic enzymes [15], tumour markers [16] urinary calculi [17] Neural networks -electrophoresis [18], serial cardiac enzymes [19] thyroid diagnosis [20] Test ordering -improving clinician ordering patterns [21] tions. Neural networks are typically organised in layers.…”