Abstract
A number of computer-based systems with diagnostic capabilities have been developed for internal medicine. Quick Medical Reference (QMR) is one such program. The authors describe key features of QMR and report on their study of its effectiveness as a diagnostic tool. They investigated how frequently the correct diagnosis would appear among the 5 highest ranked diagnoses generated by QMR. The charts of 1144 consecutive patients admitted to a teaching unit were retrospectively screened. Eligible cases included those referred for investigation of an undiagnosed illness with an objectively proven final diagnosis (n = 154). Two physicians familiar with, but not experts in, the use of QMR entered clinical information abstracted from the patients' charts into the program. Physician A obtained the correct diagnosis in 62 (40%) of the 154 cases, and physician B was successful in 56 (36%) of the cases. The authors use study cases to illustrate QMR's strengths and weaknesses.
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Selected References
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- Arene I., Ahmed W., Fox M., Barr C. E., Fisher K. Evaluation of quick medical reference (QMR) as a teaching tool. MD Comput. 1998 Sep-Oct;15(5):323–326. [PubMed] [Google Scholar]
- Bacchus C. M., Quinton C., O'Rourke K., Detsky A. S. A randomized crossover trial of Quick Medical Reference (QMR) as a teaching tool for medical interns. J Gen Intern Med. 1994 Nov;9(11):616–621. doi: 10.1007/BF02600304. [DOI] [PubMed] [Google Scholar]
- Bankowitz R. A., McNeil M. A., Challinor S. M., Parker R. C., Kapoor W. N., Miller R. A. A computer-assisted medical diagnostic consultation service. Implementation and prospective evaluation of a prototype. Ann Intern Med. 1989 May 15;110(10):824–832. doi: 10.7326/0003-4819-110-10-824. [DOI] [PubMed] [Google Scholar]
- Berner E. S., Webster G. D., Shugerman A. A., Jackson J. R., Algina J., Baker A. L., Ball E. V., Cobbs C. G., Dennis V. W., Frenkel E. P. Performance of four computer-based diagnostic systems. N Engl J Med. 1994 Jun 23;330(25):1792–1796. doi: 10.1056/NEJM199406233302506. [DOI] [PubMed] [Google Scholar]
- Giuse D. A., Giuse N. B., Miller R. A. Evaluation of long-term maintenance of a large medical knowledge base. J Am Med Inform Assoc. 1995 Sep-Oct;2(5):297–306. doi: 10.1136/jamia.1995.96073832. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Hilden J., Habbema J. D. Evaluation of clinical decision aids--more to think about. Med Inform (Lond) 1990 Jul-Sep;15(3):275–284. doi: 10.3109/14639239009025275. [DOI] [PubMed] [Google Scholar]
- Miller P. L., Sittig D. F. The evaluation of clinical decision support systems: what is necessary versus what is interesting. Med Inform (Lond) 1990 Jul-Sep;15(3):185–190. doi: 10.3109/14639239009025266. [DOI] [PubMed] [Google Scholar]
- Miller R. A., McNeil M. A., Challinor S. M., Masarie F. E., Jr, Myers J. D. The INTERNIST-1/QUICK MEDICAL REFERENCE project--status report. West J Med. 1986 Dec;145(6):816–822. [PMC free article] [PubMed] [Google Scholar]
- Miller R. A., Pople H. E., Jr, Myers J. D. Internist-1, an experimental computer-based diagnostic consultant for general internal medicine. N Engl J Med. 1982 Aug 19;307(8):468–476. doi: 10.1056/NEJM198208193070803. [DOI] [PubMed] [Google Scholar]
- Rossi-Mori A., Pisanelli D. M., Ricci F. L. Evaluation stages and design steps for knowledge-based systems in medicine. Med Inform (Lond) 1990 Jul-Sep;15(3):191–204. doi: 10.3109/14639239009025267. [DOI] [PubMed] [Google Scholar]
- Sumner W., 2nd, Shultz E. K. Expert systems and expert behavior. J Med Syst. 1992 Oct;16(5):183–193. doi: 10.1007/BF01000271. [DOI] [PubMed] [Google Scholar]
- Wolfram D. A. An appraisal of INTERNIST-I. Artif Intell Med. 1995 Apr;7(2):93–116. doi: 10.1016/0933-3657(94)00028-q. [DOI] [PubMed] [Google Scholar]
- Wyatt J., Spiegelhalter D. Evaluating medical expert systems: what to test and how? Med Inform (Lond) 1990 Jul-Sep;15(3):205–217. doi: 10.3109/14639239009025268. [DOI] [PubMed] [Google Scholar]