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© 1989 British Society for Rheumatology

research-article

A CONTROLLED EVALUATION OF DIAGNOSTIC CRITERIA IN THE DEVELOPMENT OF A RHEUMATOLOGY EXPERT SYSTEM

J. D. McCREA1,, MARGARET R. E. McCREDIE1, D. M. G. McSHERRY2 and P. M. BROOKS1

1Department of Rheumatology, University of Sydney, Royal North Shore Hospital St. Leonard's, NSW 2065 Australia
2Department of Medical Computing & Statistics, The Queen's University of Belfast, Institute of Clinical Science Grosvenor Road, Belfast BTI26BJ, UK

Correspondence to: Address for correspondence: Dr. J. D. McCrea, Department of Rheumatology, West Cumberland Hospital, Hensingham, Whitehaven, Cumbria CA288JG, UK

As an intermediate stage in the development of an expert system to support undergraduate teaching in rheumatology, a decision tree incorporating the diagnostic criteria to be used in the expert system was produced by a team of rheumatologists. In a controlled trial, 119 final-year medical students each diagnosed 10 rheumatology cases, drawn from a pool of 96 cases, with or without the aid of the decision tree.

Students who used the decision tree correctly diagnosed the following conditions more frequently than the control group: polymyalgia rheumatica (p<0.05), myopathies (p<0.01), systemic lupus erythematosus (p<0.05), pyrophosphate arthropathy (p<0.05), seronegative spondylarthropathies (p<0.0l), intra articular bleeding (p<0.05) and traumatic synovitis (p<0.05). The overall diagnostic accuracy of the students who used the decision tree was 81% compared with 68% for the control group (p<0.001).

KEY WORDS: Rheumatology, Decision tree, Diagnosis, Expert system, Medical education


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