Methods Inf Med 2003; 42(03): 212-219
DOI: 10.1055/s-0038-1634353
Original article
Schattauer GmbH

Semi-Automatic Generation of Medical Tele-Expert Opinion for Primary Care Physician

E. Biermann
1   Institute for Diabetes Research, Munich, Germany
,
J. Rihl
1   Institute for Diabetes Research, Munich, Germany
,
M. Schenker
1   Institute for Diabetes Research, Munich, Germany
,
E. Standl
1   Institute for Diabetes Research, Munich, Germany
› Author Affiliations
Further Information

Publication History

Received 11 March 2002

Accepted 12 June 2002

Publication Date:
07 February 2018 (online)

Summary

Objectives: A computer-based system has been developed for the generation of medical expert opinions on the insulin-resistance syndrome, based on clinical data obtained from primary care physicians.

Methods: An expert opinion for each patient was generated by using a decision tree for entering individual text modules and by adding optional free text. The expert opinions were returned by e-mail, telefax or by ordinary mail.

Results: 1389 primary care physician sent anonymous data sets and requested expert opinions for a total of 3768 patients. Through the set up of a rule-based system an automation of the generation of the expert opinions could be achieved and the generation time dropped from initially 40 minutes to less than 5 minutes at the end.

Conclusions: By using predefined text modules and a rule based system, a large number of medical expert opinions can be generated with relatively few additional resources.

 
  • References

  • 1 Montori SA, Smith B. Information systems in diabetes: in search of the holy grail in the era of evidence-based medicine. Exp. Clin. Endocrin.-Metab. 2001; (Suppl. 02) 109.
  • 2 de Clercq PA, Blom JA, Hasman A, Hendrikus HMK. A strategy for developing practise guidelines for the ICU using automated Knowledge acquisition techniques. J Clin Monit 1999; 15: 109-17.
  • 3 Kuilboer MM, Mosseveld BMT, Van der Lei J. Asthma Critic support for the general practitioner. In: Stevens C, de Moor G. eds Proceedings MIC ‘96. Continuga: 1996: 89-94.
  • 4 Schilling J, Faist K, Kapetanios E, Wyss P, Norrie MC, Gutzwiller F. Appropriateness and necessity research on the Internet: Using a “second opinion system”. Methods Inf Med 2000; 39: 233-7.
  • 5 Standl E. Hyperinsulinemia and atherosclerosis. Clin Invest Med. 1995; 18: 261-6. Review.
  • 6 Personal communication from: owner-leitlinienin-fo@dimdi.de
  • 7 Schneider HA, Hagemeister J, Pfaff H, Mager G, Höpp HW. Leitlinienadäquate Kenntnisse von Internisten und Allgemeinmedizinern am Beispiel der arteriellen Hypertonie. Z ärztl Qual sich (ZaeFQ) 2001; 95: 339-44.
  • 8 Biermann E, Lübben G, Rihl J, Schenker M, Standl E. Micro- and macrovascular complications in insulin sensitive and insulin-resistant diabetic patients: The IRIS Study. Diabetes. 2002 Supp. (abstract) in press.
  • 9 Sakett DL, Richardson WS, Rosenberg W, Haynes RB. Evidence-based medicine – How to practice & teach. Harcourt Brace Publishers International; 1996
  • 10 Alberti GA. Desktop guide to Type 2 diabetes mellitus. European Diabetes Policy Group; 1998. -1999.
  • 00 International Diabetes Federation European Region. Exp Clin Endocrinol Diabetes 1999; 107: 390-420.
  • 11 van Bemmel JH. Criteria for the acceptance of decision-support systems by clinicians; lessons from ECG interpretation system. Proceedings of the Artificial Intelligence in Medicine Conference AIME-93. (IOS Press), 1993: 7-10.
  • 12 Branger PJ, van’t Hoft A, van der Wouden JC, Moorman PW, van Bemmel JH. Shared care for diabetes: supporting communication between primary and secondary care. Int J Med Inform 1999; 53: 133-42.
  • 13 Rutten GE, Maaijen HM, Valkenburg CH, Blankestijn JH, de Valk HW. The Utrecht Diabetes Project: telemedicine support improves GP care in type 2 diabetes. Diabetic medicine 2001; 18: 459-63.
  • 14 van der Lei J, van der Does E, Man in’t Veld AJ, Musen MA, van Bemmel JH. Response of general practitioners to computer-generated critiques of hypertension therapy. Methods Inf Med 1993; 32: 146-53.
  • 15 Ridderikhoff J, van Herk B. Who is afraid of the system? Doctors’ attitude towards diagnostic systems. Int J Med. Inform 1999; 53: 91-100.
  • 16 Adlassnig KP, Kolarz G. CADIAG-2 : Computer-assisted medical diagnosis using fuzzy subsets. In: Approximate Reasoning in Decision Analysis. Gupta MM, Sanchez E. eds. North-Holland, Amsterdam: 1982: 219-47.
  • 17 Barahona P, Azevedo F, Veloso M, Estevao N, Gallego R. Computerising a guideline for the management of diabetes. Int J Med Inform 2001; 64: 275-84.
  • 18 Müller UA, Femerling M, Risse A. for the Working group of structured Diabetestherapy of the German Diabetes Association. HbA1c and severe hypoglycemia after intensified treatment and education of 10.000 type-1-diabetic patients. Results of a nationwide quality circle. Diabetologia 2001 44 Supp.1 A 16 (abstract).
  • 19 Borowitz SM, Wyatt JC. The origin, content and workload of e-mail consultations. JAMA 1998; 280: 1321-24.