METHOD TO TEST DIAGNOSTIC DECISION SUPPORT SOFTWARE

我们建议开发（1）一种测试诊断决策支持的方法 软件（DDSS）;（2）一套用于评估DDSS的测试规范 其领域是内科学;以及（3）样本测试，包括 DDSS系统将生成可能诊断列表的病例。 该测试将设计用于成熟的系统， 临床实践在本项目中，测试将用于比较 三种DDSS系统（DXPLAIN、QMR、MEDITEL）的性能。的方法 将遵循在这个发展过程中将基于标准 用于认证医生资格的考试中的测试开发程序 能力。因为这三个DDSS系统已经有了广泛的 发展工作，我们假设他们将表现相似， 他们所有人的分数都会高于考试的及格分数 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， 规划考试内容;（2）设计一套考试内容 （三）对检查项目种类的说明; （4）考试项目的审查和修订， （5）系统地确定合格标准;（6） 在初步评分后审查详细的项目分析 （六）考试成绩; (7)确定考试的可靠性和有效性。的 结果将是（1）一种方法，可用于开发测试， 其他类型的医疗决策支持软件，（2）一套内容 规范和一个案例协议池，可以与其他 DDSS;以及（3）三种DDSS系统在以下方面的比较性能数据： 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.