Hostname: page-component-848d4c4894-wg55d Total loading time: 0 Render date: 2024-05-16T15:13:09.477Z Has data issue: false hasContentIssue false
  • English
  • Français

Appendicitis: The Computer as a Diagnostic Tool

Published online by Cambridge University Press:  10 March 2009

John R. Clarke
John R. Clarke
Affiliation:
Medical College of Pennsylvania
Get access Rights & Permissions [Opens in a new window]

Extract

At present there is no definitive test for appendicitis and no clear set of signs and symptoms, so that diagnosis is uncertain and probabilistic. A computer model for analyzing clinical data can improve physician accuracy in diagnosing appendicitis by assessing the outcome probabilities associated with the treatment options. Should a definitive test become available, the computer model will aid clinicians in determining when to test. Once our proposed model has been validated, it will not only improve physician decision-making, but also provide quality assurance feedback, generate reports for documentation, and compile a data base of many cases for study and reference.

Type
Special Section: Technology Assessment and Surgical Policy
Information
International Journal of Technology Assessment in Health Care , Volume 5 , Issue 3 , July 1989 , pp. 371 - 379
Copyright
Copyright © Cambridge University Press 1989

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

REFERENCES

Adams, I. D., Chan, M., Clifford, P. C., Cooke, W. M., Dallos, V., de, Dombal F. T., Edwards, M. H., Hancock, D. M., Hewett, D. J., McIntyre, N., Somerville, P. G., Spiegelhalter, D. J., Wellwood, J., & Wilson, D. H.Computer aided diagnosis of acute abdominal pain: A muiticentre study. British Medical Journal, 1986, 293, 800–04.Google Scholar
Arkes, H. R., Wortmann, R. L., Saville, P., & Harkness, A. R.The hindsight bias among physicians weighting the likelihood of diagnoses. Journal of Applied Psychology, 1981, 66, 252–54.Google Scholar
Bunker, J. P., Barnes, B. A., & Mosteller, F.Costs, risks, and benefits of surgery. New York: Oxford University Press, 1977.Google Scholar
Clarke, J. R.Surgical judgment using decision sciences. New York: Praeger, 1984.Google Scholar
Clarke, J. R.A concise model for the management of possible appendicitis. Medical Decision Making, 1984, 4, 331–38.Google Scholar
Clarke, J. R., Clinical surgical decision making. In Rutkow, I. M. (Ed.), Socioeconomics of surgery. St. Louis: C. V. Mosby, 1989, 315–31.Google Scholar
Dawes, R. M.The robust beauty of improper linear models. American Psychologist, 1979, 341, 571–82.Google Scholar
Dawson, N. V., & Arkes, H. R.Systematic errors in medical decision making: Judgment limitations. Journal of General Internal Medicine, 1987, 2, 183–87.Google Scholar
de, Dombal F. T., Leaper, D. J., Staniland, J. R., McCann, A. P., & Horrocks, J. C.Computer-aided diagnosis of acute abdominal pain. British Medical Journal, 1972, 2, 9–13.Google Scholar
de, Dombal F. T., Leaper, D. J., Horrocks, J. C., Staniland, J. R., & McCann, A. P.Human and computer-aided diagnosis of abdominal pain: Further report with emphasis on performance of clinicians. British Medical Journal, 1974, 1, 376–80.CrossRefGoogle Scholar
de, Dombal F. T.Diagnosis of acute abdominal pain. Edinburgh: Churchill Livingstone, 1980.Google Scholar
Detmer, D. E., Fryback, D. G., & Gassner, K.Heuristics and biases in medical decision- making. Journal of Medical Education, 1978, 53, 682–83.Google ScholarPubMed
Fedyshin, P., Kelvin, F. M., & Rice, R. P.Nonspecificity of barium enema findings in acute appendicitis. American Journal of Roentgenology, 1984, 143, 99–102.Google Scholar
Hershey, J. C., & Baron, J.Clinical reasoning and cognitive processes. Medical Decision Making, 1987, 7, 203–11.CrossRefGoogle ScholarPubMed
Hogarth, R. M.Judgement and choice. Chichester: Wiley, 1980.Google Scholar
Koepsell, T. D., Inui, T. S., & Farewell, V. T.Factors affecting perforation in acute appendicitis. Surger, Gynecology & Obstetrics, 1981, 153, 508–10.Google Scholar
Jacobs, D. O., Clarke, J. R., Settle, R. G., Sachdeva, A. K., Wheeler, J. R., Trerotola, S. O., Wolf, G. L. & Rombeau, J. L.The identification of experimentally induced appendicitis using in vitro nuclear magnetic resonance. Journal of Surgical Research, 1985, 39, 16–24.CrossRefGoogle ScholarPubMed
Kressel, H. Y., Axel, L., Thickman, D. et al. NMR imaging of the abdomen at 0.12 T. American Journal of Radiology, 1983, 141, 1179–86.Google ScholarPubMed
Lewis, F. R., Holcroft, J. W., Boey, J. & Dunphy, J. E.Appendicitis: A critical review of diagnosis and treatment in 1,000 cases. Archives of Surgery, 1975, 110, 677–84.CrossRefGoogle Scholar
Miller, G. A.The magical number seven, plus or minus two: Some limits on our capacity for processing information. Psychological Review, 1956, 63, 81–97.CrossRefGoogle ScholarPubMed
Pauker, S. G., & Kassirer, J. P.The threshold approach to clinical decision making. New England Journal of Medicine, 1980, 302, 1109–17.CrossRefGoogle ScholarPubMed
Pliskin, N. General principles: Cost benefit and decision analysis. Decision analysis and surgical applications. In Bunker, J. P., Barnes, B. A., & Mosteller, F. (Eds.), Costs, risks, and benefits of surgery. New York: Oxford University Press, 1977, 11–21.Google Scholar
Raiffa, H.Decision analysis: Introductory lectures on choices under uncertainty. Reading, MA: Addison-Wesley, 1968.Google Scholar
Scheff, T. J.Decision rules, types of error, and their consequences in medical diagnosis. Behavioral Science, 1963, 8, 97–107.CrossRefGoogle Scholar
Trautlein, J. J., Lambert, R. L., & Miller, J.Malpractice in the emergency department – Review of 200 cases. Annals of Emergency Medicine, 1984, 13, 709–11.Google Scholar
Tversky, A., & Kahneman, D.Judgment under uncertainty: Heuristics and biases. Science, 1974, 185, 1124–31.CrossRefGoogle ScholarPubMed
Weinstein, M. C. et al. Clinical decision analysis. Philadelphia: W. B. Saunders, 1980.Google Scholar
Whitworth, C. M., Whitworth, P. S., Sanfillipo, J. & Polk, H. C.Value of diagnostic laparoscopy in young women with possible appendicitis. Surgery, Gynecology & Obstetrics, 1988, 167, 187–90.Google ScholarPubMed
Wigton, R. S.Use of linear models to analyze physicians' decisions. Medical Decision Making, 1988, 8, 241–52.Google Scholar