Abstract:
Quick Medical Reference (QMR) is a microcomputer-based decision sup´port system designed
to provide diagnostic assistance in the field of internal medicine. In addition to
providing plausible diagnostic hypotheses based upon patient specific findings, the
program highlights history, physical and laboratory items which are potentially useful
in discriminating among the diagnoses under consideration. We have evaluated the impact
of a computer-assisted diagnostic consultation service on the diagnostic and management
strategy of a housestaff in a university internal medicine training program. Differential
diagnoses were obtained before and after the use of the program, and a questionnaire
was used to asses the educational value of the service and the effect of the service
on the diagnosis and planned management. Over an eight week period, 31 cases were
identified which met inclusion criteria. The QMR consultation added a diagnosis to
the original list in 14 out of 31 cases. The consultation reordered the diagnosis
in an additional 7 cases, and in 8 cases a diagnosis was ruled out by the use ofthe
program. After the use of the program the housestaff reported they would obtain an
additional lab test in 10 cases, change the order of planned tests. in two cases and
eliminate a lab test in one case. The use of the program V)las rated as helpful educationally
in 81 % of the cases, and helpful with respect to management in also 81 % of the cases.
Key-Words:
Medical Informatics Applications - Decision Support Systems - Computer-Assisted Diagnosis
- Information Systems - Education
