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At least 757 records · Page 42Linked to original sources
PubMed2005

Field evaluation of malaria rapid diagnostic tests for the diagnosis of P. falciparum and non-P. falciparum infections.

The objective of this study was to evaluate various malaria rapid diagnostic tests as a tool in the detection of P. falciparum and non-P. falciparum infections in field conditions. Four field surveys were conducted in malaria-endemic areas of Palawan and Davao del Norte, Philippines to validate the various rapid diagnostic tests, namely Diamed OptiMAL 48 (DiaMed AG, Switzerland), ParaHIT f (Span Diagnostics, India), Orchid OptiMAL, and Paracheck Pf (both from Orchid Biomedical Systems, India). The results of the various rapid diagnostic tests were compared to those of microscopy. Sensitivity, specificity and detection rates according to the level of parasitemia were used as parameters to describe the performance of the various rapid diagnostic tests in the field. Practical and operational assessments were also done. The results of the study show that the sensitivity and detection rates were generally lower than previously reported, with sensitivities ranging from 4.8% to 20.6%, except for Diamed OptiMAL 48, which had sensitivities of 78.8% to 96.8%, and detection rates of 50.0% to 96.8%. The rest had detection rates ranging from 0.0% to 50.0%. All the specificities ranged from 18.2% to 100.0%. Improper conditions at the time of manufacturing, storage, transport, and utilization may affect the validity of the results. Rapid diagnostic tests for malaria provide practical means of detecting malarial infections, especially in endemic areas. However, issues regarding variability in performance must to be addressed before they can be used as mainstream diagnostic tools.

Algorithms↗
PubMed2005

Diagnostic accuracy of commercial system for computer-assisted detection (CADx) as an adjunct to interpretation of mammograms.

PURPOSE: To evaluate the diagnostic accuracy of the commercial computer-aided detection CADx system for the reading of mammograms. MATERIALS AND METHODS: The study assessed the Second Look system developed and marketed by CADx Medical Systems, Montreal, Canada. The diagnostic sensitivity was evaluated by means of a retrospective study on 98 consecutive cancers detected at screening by double independent reading. The specificity and the positive predictive value (PPV) for cancer of the CADx system were prospectively evaluated on a second group of 560 consecutive mammograms of asymptomatic women not included in screening program. The radiologist who was present during the test assessed the abnormal mammographic findings by one or more of the following diagnostic procedures: physical examination, additional mammographic detail views with or without magnification, ultrasonography, ultrasound- or mammography-guided fine needle aspiration cytology, and core-biopsy. The exams first underwent conventional reading and then a second reading carried out with the aid of the CADx system. RESULTS: The overall diagnostic sensitivity of the CADx system on the 98 screening cancers was 81.6%; in particular it was 89.3% for calcifications, 83.9% for masses and only 37.5% for architectural distortion. The CADx markings for each mammography were 4.7 on average. Identification of invasive carcinoma was independent from tumour size. In the second group of 560 mammograms, the CADx system marked all cases identified as positive by conventional reading and confirmed by biopsy (7/7), but did not permit the detection of any additional cancer. The CADx markings per exam were 4.2 on average, the specificity was 13.7% and the PPV was 0.55% versus 13.7% recall rate of conventional reading. CADx reading led to a 1.96% (11/560) increase of the women necessitating further diagnostic investigation. CONCLUSIONS: The results of our study show that the diagnostic sensitivity of the CADx system is lower than that obtained by double independent reading at screening. Used in association with conventional reading of mammograms of asymptomatic women the CADx system did not increase diagnostic sensitivity.

Breast Neoplasms↗
PubMed2005

Evidence-based development of a diagnosis-dependent therapy planning system and its implementation in modern diagnostic software.

The prerequisite for structured individual therapy of craniomandibular dysfunctions is differential diagnostics. Suggestions for the structured recording of findings and their structured evaluation beyond the global diagnosis of "craniomandibular disorders" have been published. Only this structured approach enables computerization of the diagnostic process. The respective software is available for use in practice (CMDcheck for CMD screening, CMDfact for the differential diagnostics). Based on this structured diagnostics, knowledge-based therapy planning is also conceivable. The prerequisite for this would be a model of achieving consensus on the indicated forms of therapy related to the diagnosis. Therefore, a procedure for evidence-based achievement of consensus on suitable forms of therapy in CMD was developed first in multicentric cooperation, and then implemented in corresponding software. The clinical knowledge of experienced specialists was included consciously for the consensus achievement process. At the same time, anonymized mathematical statistical evaluations were used for control and objectification. Different examiners form different departments of several universities working independently of one another assigned the theoretically conceiveable therapeutic alternatives to the already published diagnostic scheme. After anonymization, the correlation of these assignments was then calculated mathematically. For achieving consensus in those cases for which no agreement initally existed, agreement was subsequently arrived at in the course of a consensus conference on the basis of literature evaluations and the discussion of clinical case examples. This consensus in turn finally served as the basis of a therapy planner implemented in the above-mentioned diagnostic software CMDfact. Contributing to quality assurance, the principles of programming this assistant as well as the interface for linking into the diagnostic software are documented and also published here.

Clinical Protocols↗
PubMed2006

[Embryo and fetal pathology in routine diagnostics: what has changed and what needs to be changed].

The Authors have focused on the most important feto-neonatal and placental diseases in order to develop modern diagnostic tools which can meet the needs of clinicians (obstetricians, gynecologists, and neonatologists) for the best possible management of both the mother and the newborn. Although far from being operational instructions, it should be intended as a programmatic document providing a guideline on the issues that have cropped up in eight years of work of the APEFA group, as well as during several residential and practical classes. First of all, a synopsis is provided of the main issues concerning placental diagnosis in the newborn, as well as in case of fetal loss. A reasoned review is then provided of the main diagnostic criteria in placental pathology, in the light of therapeutical measures toward the mother (monitoring of future pregnancies) and the newborn (management of newborns at risk or with infectious disease). Legal issues in case of fetal distress at the end of pregnancy, neonatal damage and peripartum death have also been discussed with particular attention. Early and late miscarriages have also been separately examined, as well as fetal deaths. For each of these categories, a critical analysis is presented of current issues, followed by some considerations on the development of diagnostic methods and technology, and a modern diagnostic process is then outlined. Reference tables are also provided for diagnostic, auxological parameters, as well as on essential procedures. Issues concerning legal abortions and terminations of pregnancies have also been considered, with particular reference to tests and supplemental genetic and ultrasound examinations, diagnostic questions about malformations and forensic medicine assessments that are often involved with these specific categories. Malformations, fetal distress and growth retardation, sudden fetal and neonatal death, as well as embryo-pathology are all briefly dealt with also with synoptic tables. Diagnostic criteria are thus optimized and specially aimed at solving "human reproduction pathology" issues.

Abortion, Induced↗
PubMed2005

Diagnostic utility of facet (zygapophysial) joint injections in chronic spinal pain: a systematic review of evidence.

BACKGROUND: Chronic refractory spinal pain poses a peculiar diagnostic challenge because of multiple putative pain sources, overlapping clinical features, and nonspecific radiologic findings. Diagnostic injection techniques are employed to isolate the source(s) of pain. Facet or zygapophysial joint pain is an example of spinal pain diagnosed by local anesthetic injections of the facet joint or its nerve supply. Diagnostic facet joint injections are expected to meet the cardinal features of a diagnostic test (i.e., accuracy, safety and reproducibility). Accuracy must be compared with a "gold" or criterion standard that can confirm presence or absence of a disease. There is, however, no available gold standard, such as biopsy, to measure presence or absence of pain. Hence, there is a degree of uncertainty concerning the accuracy of diagnostic facet joint injections. OBJECTIVES: To evaluate accuracy, safety and reproducibility of facet or zygapophysial joint injections in diagnosing chronic spinal pain of facet joint origin. STUDY DESIGN: A systematic review of the literature for clinical studies on efficacy and utility of facet joint/nerve injections in diagnosing spinal pain from facet joints. METHODS: Relevant literature on diagnostic facet injections was identified through database searches. Excluded were abstracts, reviews, book chapters, case reports and studies based on single blocks or blocks without radiologic control. Prospective studies with placebo control, or controlled comparative local anesthetic blocks, were given priority over retrospective studies. Each study was graded using AHRQ and QUADAS criteria. The level of evidence was classified as conclusive, strong, moderate, limited, or inconclusive. RESULTS: Available literature pointed to strong evidence for controlled comparative local anesthetic facet joint medial branch blocks in the diagnosis of neck and low back pain. There was moderate evidence in the diagnosis of pain arising from thoracic facet joints. CONCLUSION: The evidence obtained from literature review suggests that controlled comparative local anesthetic blocks of facet joint nerves (medial branch or dorsal ramus) are reproducible, reasonably accurate, and safe. The sensitivity, specificity, false-positive rates, and predictive values of these diagnostic tests for neck and low back pain have been validated and reproduced in multiple studies.

Journal Article↗
PubMed2005

A systematic review of diagnostic utility of selective nerve root blocks.

BACKGROUND: Transforaminal epidural injections, or selective nerve root blocks, are used for a myriad of different spinal disorders. A clear consensus on the use of selective nerve root injections as a diagnostic tool does not currently exist. Additionally, the effectiveness of this procedure as a diagnostic tool is not clear. OBJECTIVE: The objective was to evaluate the accuracy of selective nerve root injections in diagnosing spinal disorders. STUDY DESIGN: The study involved a systematic review of diagnostic studies about selective nerve root blocks for the diagnosis of spinal pain. METHODS: A systematic review of the literature for clinical studies was performed to assess the accuracy of selective nerve root injections in diagnosing spinal disorders. Methodologic quality evaluation was performed utilizing AHRQ and QUADAS criteria. The methodology of the studies was graded and the evidence was classified into five levels: conclusive, strong, moderate, limited, or indeterminate. RESULTS: There is limited evidence on the effectiveness of selective nerve root injections as a diagnostic tool in spinal disorder. There is insufficient research into this area for strong support, but the available literature is supportive of selective nerve root injections as a diagnostic test in equivocal radicular pain. The current analysis provides moderate evidence of transforaminal epidural injections in the preoperative evaluation of patients with negative or inconclusive imaging studies. CONCLUSIONS: Selective nerve root injections may be helpful as a diagnostic addition in evaluating spinal disorders with radicular features, but the role of this diagnostic test needs to be further clarified by additional research and consensus on technique.

Journal Article↗
PubMedDate not supplied

Development and validation of diagnostic criteria for carpal tunnel syndrome.

PURPOSE: To develop clinical diagnostic criteria for carpal tunnel syndrome (CTS) that modeled the clinical diagnostic practices of experts. METHODS: Fifty-seven clinical findings associated with CTS had been ranked previously in order of diagnostic importance using Delphi as a method of establishing consensus among a panel of expert clinicians. The 8 most highly ranked criteria then were placed into all possible combinations to create 256 unique case histories. Two new panels of experts rated these case histories. One panel made a binary evaluation as to whether the case history did or did not represent CTS. This allowed the development of a logistic regression model that had the probability of carpal tunnel syndrome as the dependent variable and the weighted diagnostic criteria as the independent variables. This model then was validated against the judgments of the second panel of clinicians who estimated the probability of CTS for each of the same case histories. RESULTS: The correlation between the probability of CTS predicted by the model and the panel of clinicians was 0.71. CONCLUSIONS: The most important clinical diagnostic criteria for CTS as identified from a larger pool of potential diagnostic items through a consensus approach using Delphi were weighted and found to correlate well with the judgments of a new panel of clinicians. By improving the consistency of the diagnosis of CTS these criteria should lead to more effective treatment and a better understanding of the effect of workplace exposures in the development of this condition. A methodology that emphasizes a rigorous approach to item generation and item reduction through expert consensus, followed by validation, may represent a template for establishing consensus among experts on other controversial clinical issues. TYPE OF STUDY/LEVEL OF EVIDENCE: Diagnostic, Level I.

Carpal Tunnel Syndrome↗
PubMed2006

[BMW diagnostic criteria for IBS].

Rome I diagnostic criteria for IBS was published in 1992 and it became a global diagnostic criteria. However, the criteria was not practical and somewhat complicated. Moreover, its symptomatic duration was too long (defined as more than 3 months) to be introduced in clinical practice. Therefore, Japanese member of BMW(Bowel Motility Workshop) tried to develop a new diagnostic criteria for IBS and it was established in 1995 by way of the Delphi method. The criteria was named as BMW diagnostic criteria and it was shown below: BMW diagnostic criteria for IBS (1995) At least one month or more of repetitive symptoms of the following 1) and 2) and no evidence of organic disease that likely to explain the symptoms. 1) Existence of abdominal pain, abdominal discomfort or abdominal distension 2) Existence of abnormal bowel movement (diarrhea, constipation) Abnormal bowel movement includes at least one of the below; (1) Abnormal stool frequency (2) Abnormal stool form (lumpy/hard or loose/wartery stool) Moreover, the following test should be performed as a rule to exclude organic diseases. (1) Urinalysis, fecal occult blood testing, CBC, chemistry (2) Barium enema or colonofiberscopic examination The other diagnostic criteria for IBS was also reviewed and their characteristics were compared with BMW diagnostic criteria.

Humans↗
PubMed1991

Postoperative sepsis: reexplore or observe? Accurate indication from diagnostic abdominal paracentesis.

OBJECTIVE: To determine if postoperative diagnostic abdominal paracentesis is a useful clinical tool in the abdominal evaluation of the critically ill septic patient. DESIGN: Retrospective review. SETTING: Surgical ICU patients in a Veterans Administration medical center. PATIENTS: Ten patients were studied from a total of 1,053 patients admitted to the surgical ICU between September 1985 and May 1989. INTERVENTIONS: Diagnostic abdominal paracentesis performed by the open or closed approaches. MEASUREMENTS AND MAIN RESULTS: Results are presented in three patient groups (A, B, and C): Group A (n = 4) had positive diagnostic abdominal paracentesis. Abdominal causes for the sepsis were found at reexploration. One of these four patients survived. Group B (n = 3) had negative diagnostic abdominal paracentesis. No abdominal septic source was found at reexploration; all three patients died. In group C (n = 3), diagnostic abdominal paracentesis was negative, patients were not reexplored, and all survived. Diagnostic accuracy correlated with three variables: a) the gross appearance and smell of the fluid, b) WBC count greater than 5000 or less than 500/mm3, and c) Gram stain demonstrating bacterial organisms. CONCLUSIONS: Diagnostic abdominal paracentesis proved accurate, reliable, simple, safe, and rapid in evaluating the abdomen in the postoperative septic patient. The use of this procedure should be considered in postoperative septic patients in whom an abdominal source for the sepsis needs to be excluded.

Adult↗
PubMed1990

Information content of diagnostic tests in the medical literature.

Diagnostic tests provide information about the presence or absence of disease. However, even after application of diagnostic tests, significant uncertainty about the state of the patient often remains. This uncertainty can be quantified through the use of information theory. The "information" contained in diagnostic tests published in the medical literature of the years 1982 through 1986 was evaluated using Shannon information functions. Information content, averaged over all prior probabilities of disease, ranged from 0.002 bits to 0.720 bits of information; the tests therefore provided from 0.3% to 100% of the information needed for diagnostic certainty. Median average information was 0.395 bits, corresponding to only 55% of the information required for diagnostic certainty. Reclassifying test results into multiple mutually exclusive outcome categories allowed extraction of a median of 14% and a maximum of 109% more average information than that obtained using a dichotomous positive/negative classification. We conclude that the "information" provided by many of the tests published in the medical literature is insufficient to overcome diagnostic uncertainty. Information theory can quantify the uncertainty associated with diagnostic testing and suggest strategies for reducing this uncertainty.

Humans↗
PubMed1988

The identifier concept: variables to stratify patient costs within cardiothoracic surgical diagnostic related groups.

Prospective payment systems using the diagnostic related group payment mechanism are changing the economic incentives offered to hospitals. This study of all cardiothoracic surgical patients (N = 1825) treated during a 2-year period at an academic medical center demonstrated that patients within cardiothoracic diagnostic related groups could be stratified as to resource consumption (i.e., hospital cost) by four clinical variables: intensive care unit or emergency admission and blood and plasma product utilization. Patients within each diagnostic related group with the variable had higher hospital costs as follows: intensive care unit (100% of patients had higher costs per diagnostic related group for intensive care unit versus non-intensive care unit admissions), blood (100% of patients), plasma product (100%), and emergency admission (92.2%). In addition, hospital costs increased as the factors accumulated. This study demonstrates that costs within cardiothoracic diagnostic related groups may be grouped by four clinical parameters that occur during the patient's hospital stay. One of these variables (i.e., emergency admission) may be suitable to modify diagnostic related group payment. The other variables could segment higher cost patients within a diagnostic related group; cost containment efforts directed at these patients might then provide savings for the hospital.

Blood Transfusion↗
PubMed1988

Diagnostic peritoneal lavage in intra-abdominal sepsis.

Despite the advent of sophisticated diagnostic technology the diagnosis of the surgical abdomen in the Intensive Care Unit continues to pose a problem for the surgeon. A retrospective analysis was carried out to evaluate the utility of diagnostic peritoneal lavage to diagnose intra-abdominal surgical disease. Diagnostic peritoneal lavage was carried out in patients in whom the physical exam was deemed unreliable, such as in patients with cardiopulmonary instability or mental obtundation. Patients were included in the study if autopsy or laparotomy confirmation of the lavage data was available. Forty four patients met the inclusion criteria and formed the basis of this study. Of the twenty three patients with a positive lavage, three false-positive diagnostic peritoneal lavages were discovered, either at laparotomy or postmortem exam. Of the twenty one patients where diagnostic peritoneal lavage was negative, no false-negatives were discovered at autopsy or laparatomy. Therefore, this test is 100 per cent sensitive and 88 per cent specific. It is concluded that a negative diagnostic peritoneal lavage makes intra-abdominal surgical disease highly unlikely. However, a positive lavage may require further diagnostic work-up.

Abdomen↗
PubMed1975

Diagnostic value of routine liver tests.

In 131 patients on a medical service and 97 patients on a surgical service, in whom a diagnosis of hepatobiliary disease was verified in the hospital, the diagnostic value of routine liver tests performed soon after admission was evaluated by stepwise discriminant analysis. By measurements of alanine aminotransferase, alkaline phosphatases, gamma globulin, prothrombin time, bilirubin, and albumin, half of the medical patients were correctly classified into one of seven diagnostic categories. Aminotransferase contributed most to the classification, being twice as effective as random allocation. Decreasing the number of diagnostic categories to three (hepatitis, fatty liver, and chronic liver disease) increased the frequency of correct allocation to 80%. The allocation of all the patients to seven medical and four surgical diagnostic categories by means of four tests (aminotransferase, alkaline phosphatases, prothrombin time, and bilirubin) was significantly improved by each step with a misclassification rate of 55% when all tests were used. A reduction of the diagnostic groups to five (hepatitis, fatty liver, chronic liver disease, duct obstruction and tumor) increased the frequency of correct allocation to 63%. The analysis demonstrates the limited diagnostic effectiveness of routine liver tests when used alone. The absolute discrimination values depend on the a priori frequencies of the diagnostic groups investigated, and therefore may vary from time to time and from place to place.

Alanine Transaminase↗
PubMed1980

Assessment of diagnostic tests.

An increasing number of clinicians is to day aware of the need to assess their diagnostic tools. Despite the fact that monetary value is only one of the components of the cost of a diagnostic test, economical problems are decisive stimuli for such an effort. Any diagnostic test involves a cost which is borne by the patient. So, test request is admissible only if its result may provide an useful information to the clinician. Behind this apparently simple formulation, one can foresee difficulties arising from the fact that criteria of judgement are essentially subjective, both for the cost and the usefulness. Several indices such as sensitivity, specificity, predictive values and accuracy, are commonly used for the assessment of the diagnostic value of a test. But these indices are not always calculated from valid data. And biases and lack of precisions are sometimes an obstacle to the transferability of the conclusions. Running from the most simple to the most complex, the aim of the assessment may be: 1. To judge the diagnostic value of a single test by reference to the final diagnosis or to the clinician's initial hypothesis. 2. To compare two diagnostic tests A and B and to discuss the possible interest of their combination. 3. To define the exact place of a test in a complex diagnostic strategy. In each of these situations, an ideal protocol can be envisaged. It will be often difficult to apply. But it will help to an informative description of both data and results, making easier utilisation of the conclusions of the study by the whole medical community.

Clinical Trials as Topic↗
PubMed1995

Diagnostic accuracy and short-term surgical outcomes in cases of suspected acute appendicitis.

OBJECTIVE: To test the hypothesis that, with modern diagnostic methods and antibiotics, more conservative use of surgery in cases of suspected appendicitis would not result in increased rates of short-term complications in confirmed cases. DESIGN: Population-based observational study using administrative data. SETTING: All Ontario hospitals in which primary appendectomy was performed from Apr. 1, 1981, to Mar. 31, 1992. PATIENTS: All 126,815 patients admitted to hospital for a primary appendectomy during the study period. OUTCOME MEASURES: Diagnostic accuracy rate (acute appendicitis as the primary diagnosis), perforation rate, in-hospital death rate and length of stay. RESULTS: The diagnostic accuracy rate among the male patients was stable throughout the decade; among the female patients it rose significantly, from 71.7% in 1981 to 75.3% in 1991 (p < 0.01). The perforation rates increased significantly among both the female and male patients (p < 0.01), whereas the mean length of stay decreased (p < 0.05). Despite sex-related differences in the accuracy rates, the male and female patients had similar in-hospital death rates and mean lengths of stay. The institutional diagnostic accuracy rates, as determined from data for 1989-90 to 1991-92, ranged from 50.0% to 96.7%. Multivariate analyses of 27,189 confirmed cases of appendicitis at 175 hospitals revealed that perforation was a strong predictor of in-hospital death (odds ratio [OR] 2.46, 95% confidence interval [CI] 1.24 to 4.88), but comorbidity was the strongest predictor (OR 11.50, 95% CI 5.96 to 22.10). For each 10% increase in the diagnostic accuracy rate, the perforation rate increased 14% (OR 1.14, 95% CI 1.10 to 1.19), but the accuracy rate was not significantly related to the in-hospital death rate or the length of stay. CONCLUSION: A higher diagnostic accuracy rate is associated with more perforated appendixes. Although perforation itself leads to adverse outcomes, a higher accuracy rate does not. This suggests that hospitals with higher accuracy rates incur more perforations, but, with close observation, timely laparotomy and the use of modern antibiotics, these patients have favourable outcomes. This contrasts with adverse effects of perforation among patients at high risk for perforation (especially very young children and elderly people) in centres at all accuracy levels. The variation in hospitals' diagnostic accuracy rates suggests that some proportion of appendectomies could be safely avoided.

Abdominal Pain↗
PubMed1993

Uses of diagnostic expert systems in clinical care.

The development and testing of computerized systems to assist in the diagnostic process is a time honored research activity in medical information science. The focus of the majority of the applications produced is on providing accurate diagnostic suggestions when appropriate clinical information is entered. We believe that diagnostic knowledge has a much wider range of uses than that of simply assigning diagnostic labels. Below we describe three applications which illustrate alternate uses for diagnostic systems. Applications that assist in data collection, assess the quality of medical reports, and extract relevant clinical data from natural language x-ray reports are discussed. We believe that more effort should be directed toward studying the use of diagnostic knowledge bases in processes that help plan diagnostic strategies, in quality assurance applications, and in processes that facilitate all aspects of medical communication.

Clinical Medicine↗
PubMed1996

Radioiodine uptake in thyroid cancer patients after diagnostic application of low-dose 131I.

The aim of this study was to investigate the influence of the diagnostic administration of 74 MBq 131I on subsequent uptake of therapeutic radioiodine in thyroid cancer patients. Retention measurements were performed using a whole-body counter in 24 patients 6 weeks after total thyroidectomy. Profile scans were performed 2, 24, 48 and 72 h after the administration of the diagnostic dose and 72 h after the administration of the ablation-therapeutic dose (4.4 GBq). The mean ( +/- S.D.) effective half-life of the diagnostic dose in thyroid remnants was 40.3 +/- 23.0 h. The uptake in the thyroid remnants of the subsequent ablation dose 72 h after administration was 30.4 +/- 19.8% of that predicted from the diagnostic study. The greater reduction in uptake was associated with the longer half-life of iodine and higher uptake in the thyroid remnants at 24 h, with a longer interval between surgery and administration of the diagnostic dose and a shorter period between administration of the diagnostic and ablation doses. Our results show that a diagnostic dose of 74 MBq 131I markedly reduces thyroid uptake of an ablation dose of 131I. This should be taken into account during radiation dose planning whenever a quantitative dosimetric study is to be performed.

Female↗
PubMed1997

Medical diagnosis, diagnostic spaces, and fuzzy systems.

The complexity and uncertainty of diagnostic information makes the diagnostic process difficult to learn, teach, and practice. Fuzzy logic methods, used successfully with complex industrial control problems, may be appropriate to model the range of uncertainties found in medical diagnostic information. A fuzzy systems model for use with diagnostic and other medical decisions is described. Combining a state space view of an animal in which each dimension of the space represents a variable of the animal with a fuzzy sets representation of the variables and states of the animal leads to a fuzzy systems model, which can be used to successfully diagnose disease. Partitioning the multidimensional state space of the animal into healthy and specific disease regions provides a diagnostic space for evaluating the health of the animal. When an input vector representing the variables of a sick animal is entered into the system, the model can provide a diagnosis and, potentially, a prognosis for that animal. The model can be implemented on a desktop computer for convenient use, and it provides a helpful geometric interpretation of the concepts of "diagnosis" and "prognosis" for teaching diagnostic reasoning. The fuzzy systems approach has advantages that are unavailable in other methods. The capability of fuzzy systems to act as universal approximators allows them to accommodate complex, nonlinear, imprecise, and even conflicting relationships to provide accurate knowledge representation. With these advantages over standard rule-based methods of modeling the medical diagnostic process, fuzzy expert systems have broad potential for use in medicine and warrant further study to determine their application and possible limitations.

Animal Diseases↗