Abstract
With the advent of electronic computers that operate in the time-sharing mode, it has become possible to develop an automated system that can assist a physician in solving clinical problems. In the present study a teletype terminal has been linked to a time-sharing computer which has been programmed to evaluate clinical and laboratory information concerning patients with acid-base disorders. The program checks the data for evidence of internal consistency and requests additional information as needed to solve the acid-base aspects of the clinical problem. If sufficient information is provided, the program generates an evaluation note designed to review with the physician the pathophysiology of the disorder and to assist him in its management. If the input data are incomplete, the program draws the most useful conclusions possible based on the data provided, specifies the limitations which pertain to these conclusions, suggests further studies designed to circumvent these limitations, and while awaiting the results, suggests appropriate interim therapeutic measures. The time required to enter a patient's data and to print the evaluation note is approximately 4 min; the cost is comparable to that of many laboratory tests.
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- BRACKETT N. C., Jr, COHEN J. J., SCHWARTZ W. B. CARBON DIOXIDE TITRATION CURVE OF NORMAL MAN. EFFECT OF INCREASING DEGREES OF ACUTE HYPERCAPNIA ON ACID-BASE EQUILIBRIUM. N Engl J Med. 1965 Jan 7;272:6–12. doi: 10.1056/NEJM196501072720102. [DOI] [PubMed] [Google Scholar]
- Brackett N. C., Jr, Wingo C. F., Muren O., Solano J. T. Acid-base response to chronic hypercapnia in man. N Engl J Med. 1969 Jan 16;280(3):124–130. doi: 10.1056/NEJM196901162800302. [DOI] [PubMed] [Google Scholar]
- CACERES C. A., STEINBERG C. A., GOMAN P. A., CALATAYUD J. B., DOBROW R. J., WEIHRER A. L. COMPUTER AIDS IN ELECTROCARDIOGRAPHY. Ann N Y Acad Sci. 1964 Sep 17;118:85–102. doi: 10.1111/j.1749-6632.1964.tb33964.x. [DOI] [PubMed] [Google Scholar]
- Goldring R. M., Cannon P. J., Heinemann H. O., Fishman A. P. Respiratory adjustment to chronic metabolic alkalosis in man. J Clin Invest. 1968 Jan;47(1):188–202. doi: 10.1172/JCI105708. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Gorry G. A., Barnett G. O. Sequential diagnosis by computer. JAMA. 1968 Sep 16;205(12):849–854. [PubMed] [Google Scholar]
- KASSIRER J. P., BERKMAN P. M., LAWRENZ D. R., SCHWARTZ W. B. THE CRITICAL ROLE OF CHLORIDE IN THE CORRECTION OF HYPOKALEMIC ALKALOSIS IN MAN. Am J Med. 1965 Feb;38:172–189. doi: 10.1016/0002-9343(65)90172-5. [DOI] [PubMed] [Google Scholar]
- Lennon E. J., Lemann J., Jr Defense of hydrogen ion concentration in chronic metabolic acidosis. A new evaluation of an old approach. Ann Intern Med. 1966 Aug;65(2):265–274. doi: 10.7326/0003-4819-65-2-265. [DOI] [PubMed] [Google Scholar]
- PIPBERGER H. V., FREIS E. D., TABACK L., MASON H. L. Preparation of electrocardiographic data for analysis by digital electronic computer. Circulation. 1960 Mar;21:413–418. doi: 10.1161/01.cir.21.3.413. [DOI] [PubMed] [Google Scholar]
- Sapir D. G., Levine D. Z., Schwartz W. B. The effects of chronic hypoxemia on electrolyte and acid-base equilibrium: an examination of normocapneic hypoxemia and of the influence of hypoxemia on the adaptation to chronic hypercapnia. J Clin Invest. 1967 Mar;46(3):369–377. doi: 10.1172/JCI105538. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Slack W. V., Hicks G. P., Reed C. E., Van Cura L. J. A computer-based medical-history system. N Engl J Med. 1966 Jan 27;274(4):194–198. doi: 10.1056/NEJM196601272740406. [DOI] [PubMed] [Google Scholar]
- Slack W. V., Peckham B. M., Van Cura L. J., Carr W. F. A computer-based physical examination system. JAMA. 1967 Apr 17;200(3):224–228. [PubMed] [Google Scholar]
- Stinebaugh B. J., Austin W. H. Acid-base balance. Common sense approach. Arch Intern Med. 1967 Feb;119(2):182–188. [PubMed] [Google Scholar]
- WARNER H. R., TORONTO A. F., VEASEY L. G., STEPHENSON R. A mathematical approach to medical diagnosis. Application to congenital heart disease. JAMA. 1961 Jul 22;177:177–183. doi: 10.1001/jama.1961.03040290005002. [DOI] [PubMed] [Google Scholar]
- WINTERS R. W., LOWDER J. A., ORDWAY N. K. Observations on carbon dioxide tension during recovery from metabolic acidosis. J Clin Invest. 1958 May;37(5):640–645. doi: 10.1172/JCI103647. [DOI] [PMC free article] [PubMed] [Google Scholar]