- Leaper, Horrocks, Staniland, and deDombal
- Real-time prospective study with 472 patients with acute abdominal pain
- Acute appendicitis
- Acute diverticular disease
- Perforated duodenal ulcer
- Non-specific abdominal pain
- Acute cholcystitis
- Acute small bowel obstruction
- Acute pancreatitis
- Two methods for computer system:
- use data previously collated from a large series of 600 real-life patients
- use physician estimates of probability
- Results:
- computer system using real-life data was significantly more effective than
unaided clinicians
- computer system using the physician estimates was often less effective than
unaided clinicians
- Bill Detmer and David Gilbertson from Stanford University
- Uses demographic and risk-factor information to calculate the benefit and
cost of various screening strategies
- benefit of preventative screening for colon cancer ranges from non-existant
to moderate
- cost = time, money, risk, and discomfort
- CAN RAP presents individualized information on the benefits and risks of
various screening strategies
- uses belief network
- risk is a function of:
- family history of colon cancer
- history of colonic polyps
- age
- risk is set to be low, intermediate, or high
- CAN RAP then selects 3 screen alternatives to present to the user
- One strategy is always never screen for colon cancer
- Other two are dependent on the patient's risk
- Ex. low risk patient might be given the alternatives:
- yearly fecal occult blood testing and
- yearly fecal occult blood testing with sigmoidoscopy every 5 years
- Again CAN RAP lists benefits and costs under all of these
alternatives
- Asks patient to rank the alternatives
- Rhea from Stanford University
- Decision support tool designed to aid non-expert radiologists in the
diagnosis of hepatic lesions seen on MRI:
- Input:
- Clinical Information
- - age
- - gender
- - ethnic background (basically: asian or non-asian)
- - pre-existing liver disease
- - known cancer
- - portal vein thrombosis
- Information inferred by the system from segmented MRI's
- - size of lesion
- - number of lesions
- - pseudo capsule
- - imaging parameters: T2 intensity, T2 relaxation time, enhancement, T1
intensity
- Knowledge contained in a belief network
- Produces differential:
- hemangioma
- metastasis
- hepatocellular carcinoma
- cholangiocarcinoma
- lymphoma
- fibrous nodular hyperplasia
- regenerating nodule
- hepatic adenoma
- focal fatty infiltration
- abscess
- simple cyst
- other
- Powsner, Riely, Barwick, Marrow, and Perry Miller from Yale
- Automated Bibliographic Retrieval Based on Current Topics in Hepatology
- Uses hierarchical list of current(key) topics in hepatology to offer
intelligent searches
- Each topic has associated "selection logic" and a tested Medline search
- Starting with a liver biopsy case record, Hepatopix evaluates the selection
logic to determine which topics may be pertinent to the case
- based on clinical findings, lab tests, critical words, etc
- physician then picks the topics that are interesting enough to warrant a
literature search
- more citations are retrieved using search strategies stored for each
topic
- Roberts, Liao, and Collins from Washington Univ.
- app for medical students and internal medicine residents who were rotating
through the GI subspecialty elective
- available on the network
- ToolBook page contained the master schedule
- linked to pages describing the activities in more detail
- hypertext
- Dutton and Friedman from Boston Univ Medical Center
- A telephone based diet counselor for use by individuals uder treatment for
elevated serum cholesterol
- DietAID = Diet Adhearnce Interventions for Dyslipidemia
- Purpose is to reinforce the variety of behavioral changes required to
affect a decrease in serum cholesterol
- Uses computer controlled digitized human speech to converse with the patient
- 6 separate conversations, which represent different food groups and topics
- DietAid inquires about patient's food consumption and dietary behavior and
asks questions about the patient's food knowledge
- - patient responds with touch tone phone
- During the "conversation" DietAid will give feedback to educate and
reinforce eating habits that are likely to reduce serum cholesterol
Nutrimate
- Bingamon, Sapsford, and Donnelly from Univ. of Cincinnati
- A Pen Computer App for Patient-Centered Nutrition Management in the
Neonatal ICU
- nutrition management strategies for the premature infant are patient
specific and require the ongoing adjustment of intakes to achieve and maintain
acceptable growth trajectories
- Current process of charting nutrition info is very tedious
- Nutrimate uses pen computer (GRID Palmpad, Fremont, CA), so this info can
be updated/obtained at the bedside
- - access to most recent orders and nutritional info for each patient