Evaluation of the efficiency of the expert medical decision making system in diagnosis acute appendicitis

Abstract

Relevance. Timely diagnosis is the basic criterion for the quality of medical care in emergency department. One of the promising directions in the prevention of diagnostic errors is the use in clinical practice of the expert decision support system (EDSS). The aim of this study was a comparative analysis of the diagnostic efficiency of EDSS in acute appendicitis (AA) at various stages of the differential diagnosis of acute abdominal pain (AAP). Materials and methods. The study performed a retrospective analysis of the diagnostic results of 150 patients with various forms of AA, followed by the processing of structured clinical, laboratory and instrumental data using the original version of EDSS. Results and Discussion. It has been established that EDSS unidirectionally and sequentially models the stages of a standard diagnostic program for examining a patient with AAP at all levels of automated assessment of symptoms and signs of AA. Depending on the final parameters of the indication, the EDSS makes it possible to differentiate the variants of AA clinical scenarios with the identification of categories of diagnostic complexity that occurred in surgical practice. The data of relevance and validity of EDSS in the differential diagnosis of AAP are presented. The role of the expert system for the intensification of the doctor’s clinical reasoning and the prevention of diagnostic errors in emergency abdominal surgery is noted. Conclusion. The data obtained indicate a comparable diagnostic efficiency of the proposed version of EDSS with the accuracy of the diagnosis of a surgeon. The results of the preclinical use of EDSS allow the clinician to recommend its use in the format of an interactive “cognitive assistant” in case of possible difficulties and doubts in the differential diagnosis of AAP.