Evaluation of BCDE, a microcomputer program to analyze automated blood counts and differentials

A relational database for diagnosis of hematopoietic neoplasms using immunophenotyping by flow cytometry

A relational database was developed to facilitate the diagnosis of hematopoietic neoplasms using results of immunophenotyping by flow cytometry. This database runs on personal computers and uses backward-chaining search to arrive at conclusions. Results of immunologic marker studies are processed by the database to obtain a set of differential diagnoses. The current version of this database includes diagnostic immunophenotyping pattern for 33 hematopoietic neoplasms. We tested this database using 92 clinical cases from 2 tertiary care medical centers. The database ranked the actual diagnosis as 1 of the top 5 differential diagnoses in 93% of the cases tested. The user can modify the database contents to suit individual needs. This database has been posted on the World Wide Web for direct access. We propose that this user-friendly database is a potential tool for computer-assisted diagnosis of hematopoietic neoplasms.

Multiparameter interpretative reporting in diagnostic laboratory hematology

Accurate diagnosis and classification of hematologic malignancies (acute leukemias and chronic lymphoproliferative disorders) requires a multiparameter approach including peripheral blood analysis, bone marrow examination, and immunophenotyping. We have designed knowledge-based computer systems for interpretation of the hemogram and peripheral blood smears, analysis of flow cytometric immunophenotyping panels, and morphologic assessment of bone marrow specimens. The 3 modules share a relational database which includes pertinent clinical history in addition to the laboratory results. The bone marrow module automatically writes a complete interpretative report with a final diagnosis by searching all of the databases for appropriate clinical, peripheral blood, and immunophenotyping information. The ability of the 3 modules to interact, and the quality of the interpretative reports were tested on 100 consecutive patients with leukemia. The final diagnosis made by the bone marrow system agreed with the hospital diagnosis in 94 cases and the authors' interpretation in 99 of 100 cases.

Medical diagnostic decision support systems--past, present, and future: a threaded bibliography and brief commentary

Articles about medical diagnostic decision support (MDDS) systems often begin with a disclaimer such as, "despite many years of research and millions of dollars of expenditures on medical diagnostic systems, none is in widespread use at the present time." While this statement remains true in the sense that no single diagnostic system is in widespread use, it is misleading with regard to the state of the art of these systems. Diagnostic systems, many simple and some complex, are now ubiquitous, and research on MDDS systems is growing. The nature of MDDS systems has diversified over time. The prospects for adoption of large-scale diagnostic systems are better now than ever before, due to enthusiasm for implementation of the electronic medical record in academic, commercial, and primary care settings. Diagnostic decision support systems have become an established component of medical technology. This paper provides a review and a threaded bibliography for some of the important work on MDDS systems over the years from 1954 to 1993.