Methods Inf Med 1978; 17(01): 15-28
DOI: 10.1055/s-0038-1636605
BAYES’ THEOREM
Schattauer GmbH

Computer Aided Diagnosis – A Review of Research

COMPUTERUNTERSTÜTZTE DIAGNOSTIK — EINE ÜBERSICHT IHRER FORSCHUNGSERGEBNISSE
Ann Wardle
,
L. Wardle
Weitere Informationen

Publikationsverlauf

Publikationsdatum:
15. Februar 2018 (online)

Computer aided diagnosis is reviewed and an assessment made of the different models used for this purpose. These are discussed under three headings:

1. Models based on physicians’ thought processes

2. Models based on the physiological relationships manifested in the disease state,

3. Statistical models.

The models are assessed in terms of their accuracy by comparison with clinical methods. Typical results show that using the computer improves diagnostic accuracy by about 10%.

It is concluded that Bayesian models are likely to give the best results since they are well suited to the probabilistic nature of medical data and can be adapted for use in many situations. Further research necessary for the improvement of Bayesian models is discussed.

In einem Bericht über computerunterstützte Diagnostik werden die verschiedenen hiez’bei benutzten Modelle beurteilt. Sie werden unter drei Überschriften erörtert:

1. Modelle, die auf gedanldiche Prozesse des Arztes gründen,

2. Modelle, die auf im Krankheitszustand manifestierte physiologische Beziehungen gründen,

3. statistische Modelle.

Die Modelle werden nach ihrer Genauigkeit im Vergleich mit klinischen Methoden beurteilt. Typische Ergebnisse zeigen, daß die Anwendung des Computers die diagnostische Genauigkeit um etwa 10% erhöht.

Es wird gefolgert, daß Bayessche Modelle die besten Ergebnisse zeitigen, da sie dem probabilistischen Charakter medizinischer Daten entsprechen und zur Anwendung in vielen Situationen angepaßt werden können. Die weiter erforderliche Forschungsarbeit zur Verbesserung Bayesscher Modelle wird erörtert.

 
  • Bibliography

  • 1 Anderson J. A, Boyle J. A. Computer Diagnosis — Statistical Aspects. Brit. med. Bull 24 1968; 230-236.
  • 1a Anderson J. A, Boyle J. A. Computer Diagnosis — Clinical Aspects. Brit. med. Bull 24 1908; 224-229.
  • 2 Bleich H. L. Computer Evaluation of Acid-Base Disorders. J. clin. Invest 4S 1969; 1689-1696.
  • 3 Bonner R. E, Evangelisti C. J, Steinbeck H. D, Cohen L. A Diagnostic Assistance Program. Meth. Inform. Med 05 1966; 114-128.
  • 4 Bouckaert A. Computer Diagnosis of Goitres. I. Classification and Differential Diagnosis. J. chron. Dis 24 1971; 299-310.
  • 5 Bouckaert A. Computer Diagnosis of Goitres. II. Syndrome Recognition and Diagnosis. J. chron. Dis 24 1971; 311-320.
  • 6 Boyle J. A, Greig W. R, Franklin D. A, Harden R. McG, Buchanan W. W, McGirr E. M. Construction of a Model for Computer Assisted Diagnosis: Application to the Problem of Non-Toxic Goitre. Quart. J. Med 35 1966; 565-588.
  • 7 Bhunk H. D, Lehr J. L. An Improved Bayes Method for Computer Diagnosis. Proceedings of the Conference on the Use of Computers in Radiology. University of Chicago. 1966
  • 8 Card W. I. The Diagnostic Process. J. Roy. Coll. Phycns London 04 1970; 183-187.
  • 9 Cobelli C, Salvan A. A Medical Record and a Computer Program for Diagnosis of Thyroid Disease. Meth. Inform. Med 14 1975; 126-132.
  • 10 Croft D. J. Is Computerized Diagnosis Possible?. Comput. biomed. Res 05 1972; 351-367.
  • 11 Davies P. Symptom Diagnosis using Bahadur’s Distribution. Bio-med. Comput 03 1972; 307-312.
  • 12 De Dombal F. T, Hoeeocks J. C. Computer-Aided Diagnosis: Conclusions from an Overall Experience Involving 4469 Patients. In Anderson J, Forsythe J. M. (Eds.) Medinfo. 1974: 581-585 North Holland Publishing Co; Amsterdam: 1974
  • 13 De Dombal FT, Leaper D. J, Horrocks J. C, Staniland J. R, McCann A. P. Human and Computer-Aided Diagnosis of Acute Abdominal Pain: Further Report with Emphasis on Performance of Clinicians. Brit. med. J 1974; I: 376-380.
  • 14 De Dombal F. T, Leapee D. J, Staniland J. R, McCann A. P, Horrocks J. C. Computer Aided Diagnosis of Acute Abdominal Pain. Brit. med. J 1972; II: 9-13.
  • 15 Edwards D A. W. Flow Charts, Diagnostic Keys and Algorithms in the Diagnosis of Dysphagia. Scot. med. J 15 1970; 378-385.
  • 16 Feinstein A. R. Taxonomy and Logic in Clinical Data. Ann. N. Y. Acad. Sei 101 1969; 450-459.
  • 17 Fraser P. M, Franklin D. A. Mathematical Models for Diagnosis of Liver Disease. Quart. J. Med 43 1974; 73-88.
  • 18 Gardner M. J, Barker D J. P. A Case Study in Techniques of Allocation. Biometrics 31 1975; 931-942.
  • 19 Garland L. H. Studies on the Accuracy of Diagnostic Procedures. Amer. J. Roentgen S2 1959; 25-38.
  • 20 Gawler J. Computer Assisted Tomography (E. M. I. Scanner). Its Place in the Investigation of Suspected Intra-Cranial Tumours. Lancet 1974; II: 419-423.
  • 21 Gill P. W, Leaper D. J, Guillou P. J, Staniland J. R, Hoerocks J. C, De Dombal F. T. Observer Variation in Clinical Diagnosis — A Computer Aided Assessment of its Magnitude and Importance in 552 Patients with Abdominal Pain. Meth. Inform. Med 12 1973; 108-113.
  • 22 Goldbeeg L. R. Simple Models or Simple Processes ?. Some Research on Clinical Judgements. Amer. Psychol 23 1968; 483-496.
  • 23 Goldberg L. R. Man versus Model of Man: A Rationale plus some Evidence for a Method of Improving on Clinical Inferences. Psychol. Bull 73 1970; 422-432.
  • 24 Good I. J, Card W. I. The Diagnostic Process with Special Reference to Errors. Meth. Inform. Med 10 1971; 176-188.
  • 25 Gorry G. A, Barnett G. O. Experience with a Model of Sequential Diagnosis. Comput. biomed. Res 01 1968; 490-507.
  • 26 Gorry G. A, Kassirer J. P, Essig A, Schwarz W. B. Decision Analysis as the Basis for Computer Aided Management of Acute Renal Failure. Amer. J. Med 55 1973; 473-484.
  • 27 Gustafson D. H, Kiestly J. J, Ludke R. L, Larson F. Probabilistic Information Processing: Implementation and Evaluation of a Semi P. I. P. Diagnostic System. Comput. biomed. Res 06 1973; 355-370.
  • 28 Gwynne J. F. Fallacies in Cancer Mortality Statistics. N. Z. med. J 64 1965; 146-151.
  • 29 Horrocks J. C, McCann A. P, Staniland J. R, Leaper D. J, De Dombal F. T. Computer-Aided Diagnosis: Description of an Adaptable System and Operational Experience with 2,304 Cases. Brit. med. J 1972; II: 5-9.
  • 30 Kagan A, Katsutci S, Sternby N, Vanecek R. Reliability of Death Certificate Data on Vascular Lesions Affecting the Central Nervous System. Bull. Wld Hlth Org 37 1967; 477-481.
  • 31 Kaplan R. J, Newman J. R. Studies in Probabilistic Information Processing. I. E. E. E. Transactions on Human Factors in Electronics 07 1966; 49-63.
  • 32 Kleinmuntz B. M. M. P. I. Decision Rules for the Identification of College Maladjustment: A Digital Computer Approach. Psychol. Monogr 77 1963; No. 14.
  • 33 Knill-Jones R. P, Stern R. B, Girmes D. H, Maxwell J. D, Thompson R P. H, Williams R. Use of Sequential Bayesian Model in Diagnosis of Jaundice by Computer. Brit, med. J 1973; I: 530-533.
  • 34 Köhler C. O, Wagner G, Wölber U. Interactive Data Processing in Medicine — Man-Machine Dialogue. Meth. Inform. Med 15 1976; 102-120.
  • 35 Kohout L. Algebraic Models in Computer Aided Medical Diagnosis. In Anderson J, Forsythe J. M. (Eds.) Medinfo. 1974: 575-579 North Holland Publishing Co; Amsterdam: 1974.
  • 36 Krischer J. P. Diagnostic Nets. Bio-med. Comput 02 1971; 27-38.
  • 37 Krischer J. P. Application of Sequential Methods in Pattern Recognition to Diagnosis. Math. Biosci 13 1972; 33-45.
  • 38 Lasker G. E. Application of Sequential Pattern-Recognition Technique to Medical Diagnosis. Bio-med. Comput 01 1970; 173-186.
  • 39 Leaper D. J, Gill P. W, Staniland J. R, Horrocks J. C, De Dombal F. T. Clinical Diagnostic Process: An Analysis. Brit. med. J 1973; III: 569-574.
  • 40 Leaper D. J, Horrocks J. C, Staniland J. R, De Dombal F. T. Computer Assisted Diagnosis of Abdominal Pain Using »Estimates« Provided by Clinicians. Brit. med. J 1972; IV: 350-354.
  • 41 Lively W. M, Szygenda S. A, Mize C. E. Modelling Techniques for Medical Diagnosis: I. Heuristics and Learning Programs in Selected Neonatal Hepatic Disease. Comput. biomed. Res 06 1973; 393-410.
  • 42 Lodwick G. S. Solitary Malignant Tumours of Bone — The Application of Predictor Variables in Diagnosis. Seminar. Roentgenol 01 1966; 293-313.
  • 43 Lusted L. B. Introduction to Medical Decision Making. Charles B. Thomas; Springfield: 111 1968
  • 44 Milliken J. A, Wartak J, Orme W, Lywood D. W, Fay J. Diagnostic Evaluation of ECG Data by Computer. C. M. A. Journal 104 1971; 801-805.
  • 45 Mize C. E, Lively W. M, Szygenda S. A. Modelling Techniques for Medical Diagnosis: II. Differential Diagnosis of Neonatal Hepatitis and Biliary Atresia. Comput. biomed. Res 09 1976; 239-245.
  • 46 Moore M. F, Aitchison J, Parker L. S, Taylor T. R. Use of Information in Thyrotoxicosis Treatment Allocation. Meth. Inform. Med 13 1974; 88-92.
  • 47 Nacke O, Wagner G. Bibliography on the Topic — »The Role of Error in Medicine; Quality Control as a Task of Medical Documentation«. Meth. Inform. Med 03 1964; 133-150
  • 48 Norusis M. J, Jacquez J. A. Diagnosis I. Symptom NonIndependence in Mathematical Models for Diagnosis. Comput. biomed. Res 08 1972; 156-172.
  • 48a NoRusis M. J, Jacquez J. A. Diagnosis II. Diagnostic Models Based on Attribute Clusters: A Proposal and Comparisons. Comput. biomed. Res S 1972; 173-188.
  • 49 Nugent C. A, Warner H. R, Dunn J. T, Tyler F. H. Probability Theory in the Diagnosis of Cushing’s Syndrome. J. clin. Endocr 24 1964; 621-627.
  • 50 Overall J. E, Williams C. M. Conditional Probability Program for Diagnosis of Thyroid Function. J. Amer. med. Ass 1S3 1963; 307-313.
  • 51 Phillips L. D, Hays W. I, Edwards W. Conservatism in Complex Probabilistic Inference. I. E. E. E. Transactions on Human Factors in Electronics 07 1966; 7-18.
  • 52 Pipberger H. V, Klingeman J. D, Cosma J. Computer Evaluation of Statistical Properties of Clinical Information in the Differential Diagnosis of Chest Pain. Meth. Inform. Med 07 1968; 79-92.
  • 53 Prutting J. Lack of Correlation between Antemortem and Postmortem Diagnosis. N. Y. J. Med 67 1967; 2081-2084.
  • 54 Rapoport A, Wallsten T. S. Individual Decision Behaviour. Ann. Rev. Psychol 23 1972; 131-176.
  • 55 Reale A, Maccacaro G. A, Rocca E, E’Intino S, Gioffre P. A, Vestri A, Motolese M. Computer Diagnosis of Congenital Heart Disease. Comput. biomed. Res 01 1968; 533-549.
  • 56 Rector A. L, Ackerman E. Rules for Sequential Diagnosis. Comput. biomed. Res S 1975; 143-155.
  • 57 Rinaldo J. A, Scheinok P, Rupe C. E. Symptoms Diagnosis: A Mathematical Analysis of Epigastric Pain. Ann. intern. Med 59 1963; 145-154.
  • 58 Rosenblatt M. B, Teng P. K, Kerpe S. Diagnostic Accuracy in Cancer as Determined by Post Mortem Examination. Prog. clin. Cancer 05 1973; 71-80.
  • 59 Ross P. Computers in Medical Diagnosis. C. R. C. Crit. Rev. Radiol. Sei 03 1972; 197-243.
  • 60 Sawyer J. Measurement and Prediction, Clinical and Statistical. Psych. Bull 66 1906; 178-200.
  • 61 Scheinok P. Symptom Diagnosis: Bayes Theorem and Bahadur’s Distribution. Bio-med. Comput 03 1972; 17-28.
  • 62 Scheinok P. A, Rinaldo J. A. Symptom Diagnosis: The Use of Two Different Mathematical Models. Bio-med. Comput 00 1971; 239-248.
  • 63 Slovic P, Lichtenstein S. Comparison of Bayesian and Regression Approaches to the Study of Information Processing in Judgement. Organis. Beliav. Hum. Perform 06 1971; 649-744.
  • 64 Spicer C. C, Jones J. H, Jones J E. L. Discriminant and Bayes Analysis in the Differential Diagnosis of Crohn’s Disease and Proctocolitis. Meth. Inform. Med 12 1973; 118-122.
  • 65 Stern R. B, Knill-Jones R. P, W’illiams R. Pitfalls in the Diagnosis of Jaundice due to Carcinoma of the Pancreas or Biliary Tree. Brit. Med. J 1973; I: 533-534.
  • 66 Stern R. B, Knill-Jones R. P, Williams R. Clinician versus Computer in the Choice of 11 Differential Diagnoses of Jaundice Based on Formalised Data. Meth. Inform. Med 13 1974; 79-82.
  • 67 Taylor T. R. Computer-Guided Diagnosis. J. Roy. Coll. Phycns (London) 04 1970; 18S-194.
  • 68 Taylor T. R, Aitchison J, McGirr E. M. Doctors as Decision Makers: A Computer Assisted Study of Diagnosis as a Cognitive Skill. Brit. Med. J 1971; III: 35-40.
  • 69 Teather D, Emerson P. A, Handley A. J. Decision Theory Applied to the Treatment of Deep Vein Thrombosis. Meth. Inform. Med 13 1974; 92-97.
  • 70 Templeton A. W, Bryan K, Waid R, Townes J, Hugue M, Dwyer S. Computer Diagnosis and Discriminant Analysis Decision Schemes. Radiology 95 1970; 47-55.
  • 71 Templeton A. W, Jansen C, Lehr J. L, Hufft R. Solitary Pulmonary Lesions, Computer-Aided Differential Diagnosis and Evaluation of Mathematical Methods. Radiology S9 1967; 605-613.
  • 72 Templeton A. W, Lehr J. L, Simmons C. The Computer Evaluation and Diagnosis of Congenital Heart Disease Using Roentgenographic Findings. Radiology S7 1967; 658-670.
  • 73 Templeton A. W, Simmons C, Lehr J. L. Computer Diagnosis of Heart Disease, the Public Model. Amer. J. Roentgenol 102 1968; 865-874.
  • 74 Van Meerten R. J, Durincic J. R, de Wit C. Computer Gviided Diagnosis of Asthma, Asthmatic Bronchitis, Chronic. Bronchitis and Emphysema. I. Description of Symptom Classes and Diseases. Respiration 2S 1971; 293-305.
  • 75 Van Meerten R. J, Dttrinck J. R, Dewit C. Computer Guided Diagnosis of Asthma, Asthmatic Bronchitis, Chronic Bronchitis and Emphysema. II. Computing Methods and Results. Respiration 2S 1971; 399-408.
  • 76 Victor N, Trampisch H. J, Zentgraf R. Diagnostic Rules for Qualitative Variables with Interactions. Meth. Inform. Med 13 1974; 184-186.
  • 77 Wagner G. Datenkontrolle. In Koller S, Wagner G. (Eds.) Handbuch der medizinischen Dokumentation und Datenverarbeitung. 267-288 F. K. Schattauer; Stuttgart: 1975
  • 78 Warner H. R, Rutherford B. D, Houtchens B. A Sequential Bayesian Approach to History Taking and Diagnosis. Comput. biomed. Res 05 1972; 256-262.
  • 79 Warner H. R, Toronto A. F, Veasy G. Experience with Bayes Theorem for Computer Diagnosis of Congenital Heart Disease. Ann. N. Y. Acad. Sei 115 1964; 558-567.
  • 80 Warner H. R, Toronto A. F, Veasey L. G, Stephenson R. A Mathematical Approach to Medical Diagnosis. J. Amer. med. Ass 177 1961; 177-183.
  • 81 Wiener F. Computer Simulation of the Diagnostic Process in Medicine. Comput. biomed. Res S 1975; 129-142.
  • 82 Wilson W. J, Templeton A. W, Turner A. H, Lodwick G. S. The Computer Analysis and Diagnosis of Gastric Ulcers. Radiology S3 1965; 1064-1073.
  • 83 Zentgraf R. A Note on Lancaster’s Definition of Higher Order Interactions. Biometrika 62 1975; 275-378.