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J R Staniland

Publications and source records attributed to J R Staniland.

25 records · Page 2Linked to original sources
PubMed1972

Computer-aided diagnosis of acute abdominal pain.

This paper reports a controlled prospective unselected real-time comparison of human and computer-aided diagnosis in a series of 304 patients suffering from abdominal pain of acute onset.The computing system's overall diagnostic accuracy (91.8%) was significantly higher than that of the most senior member of the clinical team to see each case (79.6%). It is suggested as a result of these studies that the provision of such a system to aid the clinician is both feasible in a real-time clinical setting, and likely to be of practical value, albeit in a small percentage of cases.

Abdomen, Acute↗
PubMed1971

Simulation of clinical diagnosis: a comparative study.

This paper presents a comparison between three different modes of simulation of the diagnostic process-a computer-based system, a verbal mode, and a further mode in which cards were selected from a large board. A total of 34 subjects worked through a series of 444 diagnostic simulations.The verbal mode was found to be most enjoyable and realistic. At the board, considerable amounts of extra irrelevant data were selected. At the computer, the users asked the same questions every time, whether or not they were relevant to the particular diagnosis. They also found the teletype distracting, noisy, and slow.The need for an acceptable simulation system remains, and at present our Minisim and verbal modes are proving useful in training junior clinical students. Future simulators should be flexible, economical, and acceptably realistic-and to us this latter criterion implies the two-way use of speech. We are currently developing and testing such a system.

Appendicitis↗
PubMed1971

Production of artificial "case histories" by using a small computer.

This paper describes a method of producing artificial "case histories" by using probability theory and clinical data from a series of 600 patients with acute abdominal pain. A series of 12 such cases were distributed to clinicians, medical students, medical secretaries and technicians, and members of the general public. For each "case" most clinicians concurred with the intended diagnosis. So did the medical secretaries and technicians; indeed this group were more confident of their chosen diagnoses than were the clinicians.It is suggested that clinicians are concerned to a large extent with the consequences of a diagnosis as well as its accuracy, and are motivated to some degree by a fear of the consequences of failure. They may be justified in adopting this policy, for when "errors" in diagnosis are harshly penalized the clinicians were infinitely more effective than any of the other groups.

Abdomen↗
PubMedDate not supplied

Prediction of individual patient prognosis: value of computer-aided systems.

Physicians take both diagnosis and prognosis into account when allocating treatment. However, by "prognosis" physicians usually imply a somewhat vague impression concerning large groups of patients. One possible task for decision support studies is to design and construct systems that accurately predict individual patient prognoses. The authors constructed and tested such systems in three areas of medicine (inflammatory bowel disease, upper gastrointestinal tract hemorrhage, and acute chest pain). In each area, the individual patient's symptoms were compared with a computer-held database of information via a Bayesian analysis, prior and conditional probabilities being derived from large-scale real-life surveys. Prospective trials designed to test these predictive systems by reference to test series comprising over 4,000 patients indicate that a firm prognostic prediction can generally be made; where made, the accuracy of prediction is over 90%. Ways in which this type of prediction may be of clinical value are discussed.

Adult↗