KNOWLEDGE BASED RADIOLOGY INFORMATION SYSTEM

该项目的目标是提高 放射科医生解释X光检查。 两 将研究实现这一目标的基于计算机的方法。 首先 将进行计算机生成的患者特定咨询 放射科医生在读X光片时可以使用。 它将 包括一个简短的临床总结，其要素被选择用于 它们的信息内容，鉴别诊断列表，包括 患者1至5种最可能的疾病，并列出提示 表明这些异常的X光检查结果会导致 对诊断病人的帮助最大。 第二种技术 调查将是一个计算机管理的，持续的审计， 将根据每位患者的出院诊断来帮助确定 X射线解释的平均准确度。 这 该机制可以向个体放射科医师提供反馈 关于特定的疾病和发现， 读数不理想。 将通过比较胸部X线片进行评价 在有和没有咨询/提示的情况下生成的解释 系统 将采用两种方法。 第一个将比较所有 实施前12个月内的考试， 在实施后的类似时期。 第二 将评估200个选定胸部X线片的解释差异， 由6名医生在咨询和未咨询的情况下解读的X线片 和提示。 对于这项测试，专家小组将确定 存在实际异常。 对《圣经》的诠释 200部影片将被用来测试审计系统，以确定 其结果是否与传统的 基于重读多个X射线的性能测量。 在此项目期间创建的应用程序将使用专家 HELP系统中的系统工具与一组 知识管理程序。 项目的隐含目标 是研究信息论在 放射科的准确性问题。 这些工具 将在医学上具有普遍适用性。

The goal of this project is to improve the accuracy of the radiologist as he/she interprets x-ray examinations. Two computer-based approaches to this goal will be studied. First a computer-generated, patient-specific consult will be made availabe to the radiologist at the time he reads the x-ray. It will consist of a brief clinical summary whose elements are chosen for their information content, a differential diagnostic list containing the patients 1 to 5 most likely diseases, and a list of prompts indicating those abnormal x-ray findings that would contribute the most to diagnosing the patient. The second technique investigated will be a computer-managed, continuous audit that will use the discharge diagnoses of each patient to help determine the average accuracy of the x-ray interpretations. This mechanism can provide feedback to the individual radiologists concerning the specific diseases and findings for which their readings are suboptimal. Evaluation will be through comparison of the chest x-ray interpretations generated with and without the consult/prompt system. Two approaches will be used. The first will compare all examinations from a 12-month period before implementation with those from a similar period after implementation. The second will assess the difference in interpretations on 200 select chest x- rays interpreted by six physicians with and without the consult and prompts. For this test, an expert panel will determine the actual abnormalities present. The collected interpretations of the 200 films will be used to test the audit system to determine whether its results conform with the results of traditional measures of performance based on rereading multiple x-rays. The applications created during this project will use the expert system tools in the HELP system combined with a group of knowledge management routines. An implicit goal of the project is to investigate the application of information theory to the problem of accuracy in the radiology department. These tools will have general applicability in medicine.