Abstract:
To evaluate the performance of CADIAG-II/RHEUMA as consultant in the primary evaluation
of patients visiting a rheumatological outpatient clinic, a CADIAG-II/RHEUMA consultation
was done for 54 patients and the list of generated diagnostic hypotheses was compared
to each clinical discharge diagnosis. For 26 of a total of 126 rheumatological discharge
diagnoses, no matching CADIAG-II/RHEUMA diagnosis was available. 94% of all other
discharge diagnoses were found in the list of CADIAG-II/RHEUMA hypotheses, 82% among
the first third of the list of hypotheses and 48% among the first five hypotheses.
We identified the following factors limiting the ability of CADIAG-II/RHEUMA to generate
a comprehensive and correctly ranked list of diagnostic hypotheses: (1) a large percentage
of patients with early stages of not clearly identified rheumatological conditions;
(2) the limited number of CADIAG-II/RHEUMA diagnoses compared to the large number
of known rheumatological conditions; (3) the fact that rheumato-logical diseases are
rarely characterized by a single pathognomonic feature but are usually diagnosed by
combinations of rather unspecific findings.
Keywords:
Fuzzy Set Theory - Expert Systems - Rheumatology - Evaluation - CADIAG-II
