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R L Blum

Publications and source records attributed to R L Blum.

10 recordsLinked to original sources
PubMed1986

Computer-assisted design of studies using routine clinical data. Analyzing the association of prednisone and cholesterol.

To facilitate the analysis of routine, longitudinal, clinical data, we developed a computer program called the RX Study Module. Our prototype uses a small online knowledge base of medicine and biostatistics to help create and execute a detailed statistical study design. The program identifies possible confounding variables, selects methods for controlling them, creates a statistical model, determines patient eligibility criteria, and retrieves data from records. We used the program to examine the hypothesis that daily prednisone administration elevates serum cholesterol. Data from 49 patients with chronic rheumatologic disorders were analyzed from a database of 1787 patients. A regression model was fitted to each patient's record. Changes in cholesterol were significantly correlated (p = 10(-5)) with changes in prednisone after a lag of at least 1 week and after recorded confounders were controlled: delta cholesterol = 18.4 loge(prednisone). Routinely collected patient data may become an important resource for generating and studying new medical hypotheses.

Artificial Intelligence↗
PubMed1979

Antimicrobial selection by a computer. A blinded evaluation by infectious diseases experts.

An evaluation of a computer-based consultation system called MYCIN was made. Eight independent evaluators with special expertise in the management of meningitis compared MYCIN's choice of antimicrobials with the choices of nine human prescribers for ten test cases of meningitis. MYCIN received an acceptability rating of 65% by the evaluators; the corresponding ratings for acceptability of the regimen prescribed by the five faculty specialists ranged from 42.5% to 62.5%. The system never failed to cover a treatable pathogen while demonstrating efficiency in minimizing the number of antimicrobials prescribed. The study design may be useful in assessing the performance of other computer-based clinical decision-making systems.

Adult↗