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DXplain
Additional recommended knowledge
HistoryDesigned by the Laboratory of Computer Science at the Massachusetts General Hospital, work on DXplain began in 1984 with a first version being released in 1986 [2]. Today, DXplain contains a database with crude probabilities for over 4,900 clinical manifestations that are associated with over 2,200 unique diseases, yielding a total of over 230,000 unique finding-disease interconnections [2]. Educational ToolUse of DXplain as a tool for medical consultation has been common to some institutions since it fills a gap, particularly for medical students in clinical rotations, that is not adequately covered by textbook literature [3]. The system's large and accessible knowledge base combined with its ability to formulate diagnostic hypotheses have made it a popular education tool for US-based medical schools; by 2005, DXplain was supporting more than 33,189 total users [4]. MethodologyDXplain generates ranked differential diagnoses using a pseudo-probabilistic algorithm ([5]. Each clinical finding entered into DXplain is assessed by determining the importance of the finding and how strongly the finding supports a given diagnosis for each disease in the knowledge base. Using this criterion, DXplain generates ranked differential diagnoses with the most likely diseases yielding the lowest rank. Using stored information regarding each disease’s prevalence and significance, the system differentiates between common and rare diseases. AccuracyAnalysis of accuracy has shown promise in DXplain and similar clinical decision support systems. In a preliminary trial investigation of 46 benchmark cases with a variety of diseases and clinical manifestations, the ranked differential diagnoses generated by DXplain were shown to be in alignment with a panel of five board-certified physicians [6]. In another study investigating how well decision support systems work at responding to a bioterrorism event, an evaluation of 103 consecutive internal medicine cases showed that Dxplain correctly identified the diagnosis in 73% of cases, with the correct diagnosis averaging a rank of 10.7 [7]. Clinical UsageDespite its usage in clinician training, similar to other clinical decision support systems, DXplain has not expanded beyond the research laboratory or medical training setting, due in part to a lack of support by clinicians in real-world settings [8]. References
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This article is licensed under the GNU Free Documentation License. It uses material from the Wikipedia article "DXplain". A list of authors is available in Wikipedia. |