Computer diagnosis of thyroid diseases. Comparison of incidence data and considerations on the problem of data-collection

Asymmetric Epoxidation and Sulfoxidation Catalyzed by a New Styrene Monooxygenase from Bradyrhizobium

Asymmetric epoxidation catalyzed with styrene monooxygenase (SMO) is a powerful enzymatic process producing enantiopure styrene epoxide derivatives. To establish a more diversified reservoir of SMOs, a new SMO from Bradyrhizobium sp. ORS 375, named BrSMO, was mined from the database and characterized. BrSMO was constituted of an epoxygenase component of 415 amino acid residues and an NADH-dependent flavin reductase component of 175 residues. BrSMO catalyzed the epoxidation of styrene and 7 more styrene derivatives, yielding the corresponding (S)-epoxides with excellent enantiomeric excesses (95- > 99% ee), with the highest activity achieved for styrene. BrSMO also catalyzed the asymmetric sulfoxidation of 7 sulfides, producing the corresponding (R)-sulfoxides (20-90% ee) with good yields.

Thyroid disorders: automatic diagnosis in CONSULT I

Automatic diagnosis of thyroid diseases is implemented on CONSULT I, a microcomputer system based on the Patrick model for computer-assisted diagnosis in medicine. The thyroid 'subsystem' consists of 19 classes (diseases) and 16 features (signs, symptoms, laboratory tests). For 76 test cases obtained from patient records (recognition samples), the 'true' class (disease) is decided in the highest 'probability' number in 89% of cases and in the differential diagnosis in 100% of cases. Performance is compared to physicians. Estimation of class-conditional probability densities utilizing equivalence regions in the feature space is discussed.

Clinical judgment and computers

The increasingly frequent application of formal methods, including algorithms and computer programs, to processes that are ordinarily viewed as judgmental seems to be a source of both promise and unease for physicians. A consideration of some of these methods suggests that it may be helpful to attempt to distinguish carefully between judgment and computation. Medical care involves a complex of inferential processes, any of which may be performed as judgments, and some of which may be carried out as a computation. My purpose here is to identify the latter cases. The empirical evidence suggests that such a demarcation is feasible. The most important question appears not to be "Where can we use computers?" but "Where must we use human beings?" Until this matter is more thoroughly explored, tension between physicians and computer advocates will persist.

Computer-aided medical diagnosis: literature review

The difficulty of the medical diagnostic task and the advantages of the computer as an aid in this task are discussed. The general strategy and structure of any computer-aided system is presented, and the relationship of diagnostic accuracy to key variables involved in the development, test and use of a computer-aided diagnostic system is examined. These variables include: the computer algorithm, the source of the information used to develop the data base, the number and type of diseases under investigation, the number and type of indicants used, the source of the test sample, and the source of the validated diagnosis. A table of 58 empirically tested computer-aided medical diagnostic systems is presented; each system is summarised in relation to the variables mentioned above and diagnostic accuracy.

Gathering diagnostic statistics

There is currently a dearth of numerical data on symptom occurrence for medical diseases. These data would be useful in many computer applications to medicine, particularly for computer-assisted diagnosis, computer-based clinical simulations, and computer-assisted instructions. These data might be obtained from (1) published review articles, (2) combined data bases already developed for previous automated diagnosis programs, (3) retrospective chart reviews, (4) computerized medical information systems, or (5) data supplied by expert committees. Each of these techniques has drawbacks, especially in providing data for multiple time cuts throughout the disease course, and in accounting for prior therapies, the interactions of symptoms, or the locality, sex, race, or environment of the patient. However, even a preliminary effort documenting the judgment of expert committee members would be a substantial contribution and would facilitate further progress in important areas of medical computing.