Presentation on theme: "Table 1. Comparison of laboratory investigations using the conventional approach and the LAS (Clin Chem 45:8 1168-1175 (1999) ConventionalLAS Results Mean."— Presentation transcript:
Table 1. Comparison of laboratory investigations using the conventional approach and the LAS (Clin Chem 45:8 1168-1175 (1999) ConventionalLAS Results Mean number of tests ordered32.717.8 t-Test for two related samplest = 5.4, P <0.01 Mean number of samples collected7.55.8 t-Test for two related samplest = 3.4, P <0.02 Observations Mean costs, $$232$194 t-Test for two related samplest = 3.3, P <0.05 Turnaround time (mean no. of days)3.21 Diagnostic accuracy66%100% Number of referrals120 Established guidelines: thyroid testing Mean number of tests ordered1.71.7 Total number of sample collections128 No established guidelines: hepatitis and autoimmune testing Mean number of tests ordered6.73.3 Total number of sample collections3830 Results returned negative Mean number of tests ordered4.82 Total number of sample collections149
Retrieve CommentModify if required Enter Data Generate RuleSearch Rule List Update rule listUpdate comment list RULE EXISTS Search comment List NEW RULE Enter new Comment Search Rule List
Variables Used TFT application Qualitative –Gender –Clinical details –Drug therapy Quantitative –Age –Total T4 –TSH –Free T4 –Free T3
Performance evaluation - TFT Percentage of automatically assigned interpretations (AAI) per TFT batch
TFT application statistics Number of variables specified: 8 Number of options/decision levels: 70 Number of theoretical data combinations: 20,412,000 Number of cases entered via primer knowledge bases: 1142 Number of rules: >2900 Percentage of automatically assigned interpretations [using the primer knowledge bases] –At the outset: 66% –After the first 500 patient cases: 70% –Maximum achieved: 95% Number of interpretations rejected: <1%
electrophoresis application statistics Number of variables specified: 23 (22 used in rule generation) Number of options/decision levels: 183 Number of theoretical data combinations: 8,800,000,000,000,000,000 Number of cases entered via primer knowledge bases: 206 Number of rules: 350 Percentage of automatically assigned interpretations [using the primer knowledge bases] –At the outset: 78% –After the first 500 patient cases: 72% –Maximum achieved: 70-80% Number of interpretations rejected: 0
Clinical evaluation TFT application (27 TFT requests on 15 randomly-selected new referrals to a thyroid clinic were studied; 2 evaluators participated)
Cooperative KBS output Renal KBS comment –Renal impairment with hyperkalaemia and mild hyponatraemia. [DO= renal impairment] Bone KBS comment –hypocalcaemia, raised phosphate and Alk Phos. DO = osteomalacia pattern. Integrating KBS comment –These results are consistent with renal failure and associated renal osteodystrophy
Decision Support Systems Support for Health Care Professionals
Decision Support Systems Support for Health Care Professionals Microbiology Applications –Computerised infectious disease monitor (Evans, 1986). Computer-generated alarms were produced for (1) all patients with hospital-acquired infections; (2) patients on antibiotics to which they were not susceptible; (3) who could be receiving less expensive antibiotics; (4) who were receiving prophylactic antibiotcis for too long. Use of the system saved time for hospital infection control staff, and improved antibiotic use. –MRSA monitor (Safran, Scherrer 1994). Infection control nurses were provided daily with computer-generated lab alerts giving details of MRSA+ together with re-admission alerts giving details of new admissions previously known to be colonised with MRSA. System saved time for ICNs and helped as a preventive warning.
Decision Support Systems Support for Health Care Professionals Histopathology/Cytopathology applications –PAPNET Cervical Screening Neural Network –Telepathology
Decision Support Systems Support for Health Care Professionals Haematology applications –Diamond and Nguyen/Coulter Electronics. Various DSS applications for use with Coulter systems, flow cytometry, classification of haematological malignancies etc.