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HIGH TECH MEDICINE: MAKING DIAGNOSIS WITH COMPUTER PROGRAM
Today’s doctor faces a formidable task. There are thousands of diseases. Each may have a cluster of symptoms. Some show up as patient complaints-abdominal pain in an ulcer case. Others are noted during the doctor’s examination- swelling of the ankles, perhaps, in a patient with congestive heart failure. Laboratory tests of blood or tissues reveal other signs-high blood-sugar levels in diabetes. In addition, there are X rays, stress tests, sonograms, and a dozen other diagnostic techniques. That adds up to thousands of facts that the doctor must filter through to diagnose the illness correctly. To complicate matters, diseases may have similar symptoms. Consider, for example, indigestion and heart attack.
A new computer program called DXplain can, in just a few seconds, propose a list of diagnoses based on the doctor’s input into the system. The physician takes his or her pick. The doctor might use any of 4,700 medical terms: fever, arthritis, abdominal pain, anemia, and so on. DXplain helps narrow the possibilities and suggests to the doctor how he might focus on one diagnosis. The program also explains to the doctor how the diagnosis fits the patient.
Dr. Phillip Klein, a general practitioner in Parrish, Alabama, has been consulting DXplain via telephone and his personal computer since the American Medical Association put the program on its AMA/NET computer network.
“I can practice the same kind of medicine they practice in New York City, and I’m just a rural doctor,” says Dr. Klein. “I had this 30-year-old patient with a racing heart and fearing a heart attack. I put all the data into DXplain. It came up with 10 or 12 diagnoses, most of which I rejected as way out west.”
One of the computer’s suggestions was mitral valve prolapse (MVP), a floppy heart valve. It makes your heart jiggle and scares you, but it won’t kill you.
“I sent the patient to Birmingham for tests I couldn’t do, and out popped MVP,” Dr. Klein recalls. “She’s well today. She knows she’s not going to die.”
Essentially, the computer puts an extensive medical library at the doctor’s fingertips 24 hours a day. Although other computer-diagnostic programs are available, DXplain probably is the one most accessible to doctors.
The National Library of Medicine also is developing a program to diagnose rheumatism. It’s called AI/Rheum (AI stands for artificial intelligence). Scientists have programmed the computer to think like an expert in arthritis.
In the end, the doctor is still responsible for the final diagnosis and treatment; the diagnostic programs are no more than fancy textbooks designed to help the doctor to think and to manage information.
*55/266/5*
