METHOD TO TEST DIAGNOSTIC DECISION SUPPORT SOFTWARE

我们建议开发(1)测试诊断决策支持的方法 软件(DDSS)；(2)一套评价DDSS的测试规范 其领域是内科；和，(3)由以下内容组成的抽样测试 DDSS系统将为其生成可能的诊断清单的病例。 该测试将针对成熟的系统进行设计，这些系统可用于 临床实践。在本项目中，该测试将用于比较 三种DDSS系统(DXPlan、QMR、Meditel)的性能。该方法是 将在此开发过程中遵循的标准 用于认证医生的考试中的测试开发程序 能力。因为这三个DDSS系统已经广泛地 开发工作，我们假设它们将执行类似的和 他们所有人的考试成绩都会超过及格分数。 将使用的方法包括：(1)使用测试委员会 由普通内科医生和内科专科医生组成 计划考试内容；(2)设计一套内容 (三)考试内容的种类说明； 试题的编制；(4)试题的复核和修改 考试委员会；(5)系统确定合格标准；(6) 在初步评分后对详细的项目分析进行审查 考试成绩；(6)考试成绩；以及 (七)考试信度和效度的确定。这个 结果将是(1)可用于开发测试的方法 其他类型的医疗决策支持软件，(2)一套内容 规范和CASE协议池，可与其他 DDSS；以及(3)关于三个DDSS系统在以下方面的比较性能的数据 一项系统设计的测试。

We propose to develop (1) a method for testing diagnostic decision support software (DDSS); (2) a set of test specifications for evaluation of DDSS whose domain is Internal Medicine; and, (3) a sample test consisting of cases for which the DDSS systems will produce a list of possible diagnoses. The test will be designed for mature systems that are ready to be used in clinical practice. In this project, the test will be used to compare the performance of three DDSS systems (DXPLAIN, QMR, MEDITEL). The method that will be followed in this development process will be based upon standard test development procedures used in examinations to certify physicians' competence. Because these three DDSS systems have had extensive developmental work, we hypothesize that they will perform similarly and that all of them will score above the passing score for the test. The method that will be used involves (1) the use of a test committee composed of general internists and subspecialists in Internal Medicine to plan the content of the examination; (2) design of a set of content specifications for the types of items the examination should contain; (3) construction of examination items; (4) review and revision of test items by the test committee; (5) systematic determination of passing standards; (6) review of a detailed item analysis after an initial scoring of the examination; (6) performance of a final scoring on the examination; and, (7) determination of the reliability and validity of the examination. The outcomes will be (1) a methodology that can be used to develop tests for other types of medical decision support software, (2) a set of content specifications and a pool of case protocols that can be used with other DDSS; and, (3) data on the comparative performance of three DDSS systems on a systematically designed test.