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Results for “Decision Making, Computer-Assisted”

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PubMed1976

The nature of information used in making clinical decisions in general practice.

This preliminary study indicates that in general practice:(1) Acquisition of appropriate clinical information is more often than not dependent on prior information of a highly selected kind available economically only to a personal doctor.(2) The amount of previous information which could be stored outside the brains of a personal doctor and his patient is relatively enormous and almost unlimited.(3) But, the amount of this externally stored previous information which will ever be used, referred to, or be clinically useful is minimal.(4) Logic branching systems for obtaining this essential clinical information for each episode are of two kinds. There is first the system which is universally appropriate to all patients and all diseases as a whole, a field in which the computer is becoming pre-eminent, but which also has its limitations. Secondly there is the highly personalised system, constituted by the clinical dialogue of the patient and his personal doctor, the structure of which, at present, defies any simplification and which we abandon at our peril.(5) Continuing care by group-practice teams operating under one roof eliminates the need for fragmentation of primary clinical records.(6) A simple up-dated manually-prepared paper summary of clinical problems encountered and therapeutic activity taken, may well be the essential core of this shared record. This would be backed up by the ad hoc clinical records of each health care professional as accessible, second level archives, conforming to some simple, systematic and universally accepted structure (Bjorn and Cross, 1970).It would be of great interest to know whether or not the same conclusions would be drawn from a similar study of the selected clinical problems which are dealt with by the hospital-based specialist services.

Decision Making↗
PubMedDate not supplied

Clinical patient management and the integrated health information system.

Emerging progress in clinical applications of patient care computing is identified. The essential clinical skill is understanding what data are appropriate in any given patient care situation and extracting enough information to make the correct management decision. The value of the computer has less to do with the internal intellectual process of diagnosis than its contribution to the more manifest actions in support of clinical patient management. Techniques with which the computer is assisting in improving the clinical decisionmaking process are reviewed, and a mechanism to link them to active patient care settings is described. In addition, a trend toward the integration of various independent subsystems, so that expensive resources can be optimized for patient needs, is noted.

Computers↗
PubMed1976

Computer-assisted learning in undergraduate medical teaching.

A programme of computer-assisted learning has been introduced for fifth-year medical students at Glasgow University during the teaching course in general practice. The programme allows students to make decisions on all aspects of patient care, and has the potential for combining a learning situation with an objective evaluation of skills and attitudes. The programme is popular with students and could have considerable potential in medical education.

Adult↗
PubMed1978

Attitudes of medical undergraduates in Glasgow to computer-assisted learning.

Computer-assisted learning (CAL) has been introduced as part of the undergraduate teaching course in general practice during the penultimate year of the medical course. The student is given an opportunity to make clinical decisions and to manage a case over a significant time scale. The attitudes of the students are favourable to this method of instruction.

Attitude of Health Personnel↗
PubMed2026

Artificial Intelligence and Machine Learning Applications in Fibromuscular Dysplasia: Transforming Diagnosis, Risk Stratification, and Clinical Decision-Making.

Fibromuscular dysplasia (FMD) is a non-atherosclerotic vascular disorder with heterogeneous presentations, making diagnosis and management highly dependent on imaging and clinical expertise. This narrative review examines how artificial intelligence (AI) and machine learning (ML) are transforming FMD care. AI-enhanced imaging, particularly convolutional neural network-based analysis, improves detection of the characteristic "string-of-beads" pattern on CT angiography, magnetic resonance angiography, and ultrasound, although FMD-specific validation remains limited. ML models facilitate risk stratification, prediction of disease progression, and early identification of complications such as aneurysms and stroke by integrating clinical, imaging, and genomic data. AI-driven clinical decision support systems further enable personalized treatment selection through pharmacogenomic insights and robot-assisted interventions. Despite promising real-world applications, challenges persist, including limited large-scale datasets, workflow integration, regulatory barriers, and algorithmic bias affecting underrepresented populations. Future advances in explainable AI, federated learning, and digital health integration may enable a shift toward predictive, patient-centered FMD management.

Humans↗
PubMedDate not supplied

A computer-aided system for the diagnosis of hepato-biliary diseases. A comparison with the performance of physicians.

A computer-aided system has been developed for the diagnosis of disease of the liver and biliary system. The program is based on the use of 30 indicants, all of which are available within six hours after patient's admission: 18 of them are clinical signs, 12 are laboratory parameters including routine liver-function tests. To date, the program concerns 52 hepato-biliary diseases. From the analysis of the 30 items collected in any patient, the diagnoses are computed according to Bayes' theorem and printed by decreasing order of probability. The performance of the program was tested using records of patients with fully proven diagnosis. The first diagnosis given by the computer was correct in 57 per cent of the cases. In 80 per cent, the right diagnosis was among the first four proposed. When the performance of the model was compared to that of physicians, the number of correct answers was roughly the same for the computer and for the specialists in hepatology; in contrast, the computer's responses were far better than those of general practitioners. These results demonstrate the efficiency of the program for the diagnosis of hepato-bilitary diseases and its potential interest for helping clinicians in decision-making.

Adult↗
PubMed1979

Quality assessment and the art of medicine: the anatomy of laceration care.

Assuring high quality medical care has remained an elusive goal because of several problems which have hampered development of effective medical audit programs: inadequate patient data, unreasonable evaluative criteria and insensitive audit procedures. The present study demonstrates the use of a clinical algorithm to help overcome these problems. An examination of medical record data from a series of 703 laceration patients treated in an emergency service yielded only 27 cases (4 per cent) with medical records sufficiently complete to use for auditing physician compliance with algorithmic criteria. Substituting a structured checklist for the handwritten note increased this rate to 86 per cent. A computer-assisted branching audit of 1,400 laceration cases demonstrated that 1) physician compliance with an algorithmic instruction varied significantly (p less than .001) according to the specific instruction, and 2) compliance with a given instruction varied significantly (p less than .001) across different providers. These results underscore the need for medical audit with educational feedback which is provider specific.

Connecticut↗
PubMed2026

A multi-scale fusion model based on multi-phase contrast-enhanced CT for predicting pancreatic cancer resectability.

Purpose.Develop a multi-scale fusion model (MSFM) based on multi-phase contrast-enhanced computed tomography (CECT) to predict pancreatic cancer (PC) resectability, thereby assisting expert decision-making.Methods.This retrospective study enrolled 280 patients with PC from four institutions, which were randomly divided into a training cohort (202 patients) and an independent test cohort (78 patients). Three-phase CECT images (arterial, venous, and delayed phases) were used for modeling. The MSFM comprises two sub-networks: (1) a multi-phase fusion network for extracting cross-phase shared fusion features, (2) a phase-specific branch network for capturing phase-specific features; and a post-fusion strategy to generate the final predictive score by integrating the shared fusion features and three groups of phase-specific features. Additionally, a human-machine fusion deep learning model (HMfDL) was constructed by fusing the predictive score of the MSFM with expert assessments.Results.In the independent test, the MSFM achieved an AUC (area under the receiver operating characteristic curve) of 0.8385 (95% CI: 0.7521-0.9249), accuracy of 84.62%, sensitivity of 72.00%, and specificity of 90.57%. This performance outperformed single-phase models (AUC range: 0.7638-0.7781), two-phase models (AUC range: 0.7826-0.7864), and ten states-of-the-art classifiers (AUC range: 0.7404-0.7796). The HMfDL further improved the performance, reaching an AUC of 0.8626 (95% CI: 0.7853-0.9400), accuracy of 91.03%, sensitivity of 80.00%, and specificity of 96.23%. Notably, the HMfDL corrected 58.82% of misdiagnosis made by experts.Conclusions. The MSFM effectively fuses multi-phase CECT to enable highly accurate predictions of PC resectability, and provides valuable support for expert decision-making through HMfDL.

Humans↗
PubMedDate not supplied

Towards computer analysis of pulmonary infiltration.

A feasibility study is described to provide quantitative texture measures to distinguish between normal lung, alveolar infiltrates and interstitial infiltrates. Advanced computer imaging technology and decision making processes were applied to distinguish between these textural patterns. The results, based on computer extracted quantitative measures, show an excellent separation of the three classes considered with 95% accuracy in the training phase and 90% accuracy in the testing phase.

Diagnosis, Computer-Assisted↗
PubMed1979

An approach to quality and performance control in a computer-assisted clinical chemistry laboratory.

A locally developed, computer-based clinical chemistry laboratory system has been in operation since 1970. This utilises a Digital Equipment Co Ltd PDP 12 and an interconnected PDP 8/F computer. Details are presented of the performance and quality control techniques incorporated into the system. Laboratory performance is assessed through analysis of results from fixed-level control sera as well as from cumulative sum methods. At a simple level the presentation may be considered purely indicative, while at a more sophisticated level statistical concepts have been introduced to aid the laboratory controller in decision-making processes.

Chemistry, Clinical↗