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Biomedical subjects

J A Hupp

Publications and source records attributed to J A Hupp.

2 recordsLinked to original sources

DXplain. An evolving diagnostic decision-support system.

DXplain is an evolving computer-based diagnostic decision-support system designed for use by the physician who has no computer expertise. DXplain accepts a list of clinical manifestations and then proposes diagnostic hypotheses. The program explains and justifies its interpretations and provides access to a knowledge base concerning the differential diagnosis of the signs and symptoms. DXplain was developed with the support and cooperation of the American Medical Association. The system is distributed to the medical community through AMA/NET--a nationwide computer communications network sponsored by the American Medical Association--and through the Massachusetts General Hospital Continuing Education Network. A key element in the distribution of DXplain is the planned collaboration with its physician-users whose comments, criticisms, and suggestions will play an important role in modifying and enhancing the knowledge base.

Artificial Intelligence

The treatment of depression in elderly patients.

Primary care physicians provide a large proportion of psychiatric care today, especially for elderly persons with limited resources and concomitant medical diseases. To determine the frequency and type of psychiatric care provided by internists, the experience of a large academic group practice was studied. Depression was the most frequent psychiatric diagnosis among persons over 59 years of age and the fifth most common of all diagnoses made by physicians. Consultations with psychiatrists were infrequent and were used primarily for confirmation of the diagnosis. Physicians generally treated the depression with supportive counseling and often employed pharmacologic therapy with tricyclic antidepressants. Elderly patients were less likely than younger patients to receive tricyclic antidepressants, and they received lower doses. The observed response to antidepressant drugs was positive but required at least 50 mg to be taken daily. Side effects were frequent, especially at doses greater than 100 mg/d, but generally not severe.

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