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Abstract #8779 Published in IGR 5-1
Usefulness of computers in diagnosis and therapy: the example of glaucoma
Paycha F; Nepoux GJournal Français d'Ophtalmologie 2003; 26: 409-416
AIM: Everyone only sees the errors of others. In diagnosis, errors prove difficult to detect inasmuch as medical reasoning is complex and subject to little supervision. MATERIAL: In the semiological phase of everyday diagnosis, any sign can be overlooked (error by omission), or be poorly analyzed (error by confusion). Putting forward hypotheses based on observation is hazardous whenever data are used following the tenet that "these signs call up this disease", which is the opposite of "in this disease, these signs often or sometimes occur". Moreover, comprehensive and detailed memorization is essential in order to avoid errors of omission (a hypothesis has been forgotten), or of confusion (a disease has been poorly memorized). METHOD: However vast it may be, the volume of data describing the miscellaneous signs of glaucoma is finite, and can therefore be used with well-known computer devices. The approximately 1000 signs, Ma, Mb, etc., are described by 85 signs, sa, sb, etc. These signs are standard, objective, semiologically accurate, and independent. They are logically equivalent because the value of a given sign, of greater or lesser importance, only appears afte rthe diagnosis has been ascertained. The pathological condition is exhibited as a set of enunciations: Ma = sa, sb, sc, etc. RESULTS: Written in Visual Basic, the program described here runs on a basic PC workstation. The selection of predicates incorporating the signs of clinical observations suggests the likely diagnoses; probability calculus determined the favored hypothesis and its reliability. The etiological and differential diagnoses relying on one, two, or three signs are outlined, as are therapies and contraindications. This information is comprehensive, detailed, pertinent, and updated.
Dr. F. Paycha, 39 rue Caulaincourt, 75018 Paris, France. paycha@yahoo.fr
