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At least 19 recordsLinked to original sources
PubMed1994

Modelling diagnostic skills in the domain of skeletal dysplasias.

The diagnostic model used in the medical expert system Skeletal Dysplasias Diagnostician (SDD) is discussed. The model aims to capture the diagnostic skills of domain experts. Such skills represent high level strategies which apply across different medical domains and hence the presented model is relatively generic. Preliminary evaluation of an earlier version of the diagnostic model, which yielded promising results, has led to a considerably improved model. A sample consultation given in an appendix illustrates most aspects of the current model. The paper concludes by giving the authors' practical insights into the knowledge engineering of medical diagnostic systems.

Bone Diseases, Developmental↗
PubMed1990

A unified nursing diagnostic model.

The diagnostic model proposed in this article seeks to connect the taxonomic systems of the North American Diagnosis Association (NANDA) and the American Nurses Association (ANA). Pictured as an actual tree, the NANDA taxonomic labels are the roots; the ANA psychiatricmental health taxa, the supporting branches; the fruit, the NANDA diagnostic labels. A patient case vignette illustrates how the paradigm may be used as a clinical and research tool to validate each taxonomy, with the goal of creating a unified classification system for nursing phenomena.

American Nurses' Association↗
PubMedDate not supplied

Retinoblastoma: a diagnostic model for India.

PURPOSE: Molecular genetic diagnostics for retinoblastoma are prerequisite for accurate risk prediction and effective management. Developing a retinoblastoma diagnostic model to establish a flow for laboratory tests is thus a necessity for tertiary ophthalmic institutions. An efficient diagnostic model could reduce the overall health care costs, redirect the resources to the high risk group and also avoid unnecessary worry for families. To the best of our knowledge there has hitherto been no comprehensive diagnostic model for retinoblastoma implemented in any institution in India. METHODS AND DISCUSSION: The diagnostic model demonstrates the logical and practical flow of various genetics tests like karyotyping, loss of heterozygosity analysis, molecular deletion, linkage analysis (familial cases), mutation screening of -CGA exons first and then non-CGA exons, methylation screening of RB1 and essential promoter regions screening in a laboratory. CONCLUSIONS: The diagnostic model proposed offers acomprehensive methodology to identify the causative two-hits for retinoblastomas that could be used while genetic counseling families. This model is applicable in tertiary hospitals in India and neighboring countries, which have the highest incidence of retinoblastoma and fertility rates in the world. We suggest that this diagnostic model could also be applied with modification for other cancers.

Child↗
PubMed2005

[Establishment of diagnostic model of cerebrospinal protein fingerprint pattern for glioma and its clinical application].

OBJECTIVE: To establish the diagnostic model of cerebrospinal protein profile for gliomas by surface-enhanced laser desorption/ionization time-of-flight mass spectrometry (SELDI-TOF MS) and bioinformatics. METHODS: Seventy-five samples of cerebrospinal fluid from patients with gliomas, benign brain tumors and mild brain traumas were collected. A total of 50 samples from gliomas and non-brain-tumors were divided into training sets (33 cases including 17 gliomas and 16 non-brain-tumors) and testing sets (17 cases including 5 gliomas and 12 non-brain-tumors). The cerebrospinal proteins bound to H4 chip were detected by SELDI-TOF MS, the profiles of cerebrospinal protein were gained and then analyzed with artificial neural network algorithm (ANN); and the diagnostic model of cerebrospinal protein profiles for differentiating gliomas from non-brain-tumors was established. Forty-seven of cerebrospinal samples of gliomas and benign brain tumors were divided into training sets (31 cases including 13 gliomas and 18 benign brain tumors) and testing sets (16 cases including 9 gliomas and 7 benign brain tumors), the diagnostic model of cerebrospinal protein profiles for differentiating gliomas from benign brain tumors was established based on the same method. The support vector machine (SVM) algorithm was also used for evaluation, both results were very similar, but the result derived from ANN was more stable than that from SVM. RESULT: The diagnostic model of cerebrospinal protein profiles for differentiating gliomas from non-brain-tumors was established and was challenged with the test set randomly, the sensitivity and specificity were 100% and 91.7%, respectively. The cerebrospinal protein profiling model for differentiating gliomas from benign brain tumors was also developed and was challenged with the test set randomly, the sensitivity and specificity were 88.9%, and 100%, respectively. CONCLUSION: The technology of SELDI-TOF MS which combined with analysis tools of bioinformatics is a novel effective method for screening and identifying tumor biomarkers of gliomas and it may provide a new approach for the clinical diagnosis of glioma.

Adult↗
PubMed2005

Diagnostic model of esophageal varices in alcoholic liver disease.

Esophageal varices may cause life-threatening bleeding with attendant high hospital cost. Since effective preventive modalities for variceal hemorrhage have been established, early detection of esophageal varices is critical for prevention of bleeding. Currently, endoscopic screening is widely recommended to patients who have the diagnosis of cirrhosis. However, the diagnosis of cirrhosis relies on histological evaluations, which is costly and invasive, and endoscopic screening also burdens medical resources. Recent cost-effectiveness studies suggested that empiric prophylaxis with beta-blockers may be viable in comparison with endoscopic screening in patients with cirrhosis. However, this issue need to be also evaluated taking account of societal and patient perspectives and is not yet decided. An accurate non-invasive diagnostic model to predict the presence of esophageal varices may reduce unnecessary endoscopic procedures and prophylactic medication and improve cost-benefit of these approaches. Use of an accurate serum marker for severe hepatic fibrosis may also improve accuracy of non-invasive diagnostic models. Hyaluronic acid, a serum marker for severe hepatic fibrosis, has been reported to have a high diagnostic performance in assessing the severity of hepatic fibrosis in patients with alcoholic liver disease. In this issue, a non-invasive diagnostic model including hyaluronic acid was shown to have excellent performance in excluding the presence of medium to large esophageal varices in severe alcohol abusers. Based on current evidence, the strategy of using a non-invasive diagnostic model together with a serum marker for severe hepatic fibrosis may improve cost-benefit in the prevention of variceal hemorrhage among patients with alcoholic liver disease. The independent verification of such diagnostic models is needed.

Biomarkers↗
PubMed1989

A diagnostic model and a test to assess word-finding skills in children.

There has been a diagnostic gap in the assessment of word-finding disorders in children. Although research in this area has continued to document strong correlations between word-finding skills and low reading achievement, dyslexia, language disorders, learning disabilities, and stuttering there have been no formal standardised measures for the assessment of word-finding skills in children. The purpose of this paper is to present: (1) a diagnostic model for the assessment of word finding; (2) a literature review that supports this model; (3) a formalised measure, the Test of Word Finding (TWF), which executes this diagnostic model for children. The assessment model includes variation in stimulus context (multiple naming sections); incorporates indices traditionally used to define word-finding problems in adults and children (accuracy, response time, response analysis and secondary characteristics); and provides for a comprehension assessment of naming errors. Components of this model are discussed with respect to stimulus context, target word frequency, nature of the target word and facilitating cues.

Child↗
PubMed1988

A clinical diagnostic model for the assessment of asbestosis: a new algorithmic approach.

Asbestosis, one of the pneumoconioses that is defined by a set of clinical, radiographic, and pathologic findings, occurs as a result of exposure to asbestos fibers. Several approaches have attempted to describe the presence, progression, or extent of asbestosis. However, these approaches have attempted to describe the presence, progression, or extent of asbestosis. However, these approaches have limitations or lack correlations with other diagnostic modalities. We propose a comprehensive clinical diagnostic model that uses the sensitivities and specificities of the various clinical, radiographic, and pathologic findings to generate a set of "likelihood numbers." These likelihood numbers, contribute to the calculation of a value that can indicate the probability of asbestosis. The clinical diagnostic model is heuristic in that a specific feature supportive of the diagnosis of asbestosis may be tested as to its sensitivity and specificity, and new features may be added to the model. The model also indicates how probabilistic a given set of findings is in the diagnosis of asbestosis and suggests what additional data may make the diagnosis more or less statistically probable. Regarding the radiologic considerations of asbestosis, the strength of the clinical diagnostic model is that it is capable of supporting a diagnosis of asbestosis in the presence of a normal chest radiograph and, conversely, may reject the diagnosis of asbestosis despite the radiographic finding of pulmonary fibrosis.

Algorithms↗
PubMed2000

Using the Master Diagnostic Model to enhance restorative success in implant treatment.

Pretreatment planning is the most important step for definitive diagnosis and treatment. Often, the pretreatment phase consists of a radiograph and study models without confirmation of the patient's jaw relationships and how they affect dentition. The Master Diagnostic Model waxing technique confirms jaw relationships and determines which hard and soft tissues should be replaced on the articulated models. In addition, this technique allows the patient to observe and comprehend what the final result will resemble. Documentation of patients with various clinical situations using the Master Diagnostic Model technique is presented.

Alveolar Ridge Augmentation↗
PubMed2003

Determining cost-effectiveness and cost component of three malaria diagnostic models being used in remote non-microscope areas.

This cross-sectional experimental study developed a methodology to analyze the cost-effectiveness of three malaria diagnostic models: microscopy; on-site OptiMAL; and on-site Immunochromatographic Test (on-site ICT), used in remote non-microscope areas in Thailand, from both a public provider and patient perspective. The study covered six areas in two highly malaria-endemic areas of provinces located along the Thai-Myanmar border. The study was conducted between April and October 2000, by purposively recruiting 436 malaria suspected cases attending mobile malaria clinics. Each patient was randomly selected to receive service via the three diagnostic models; their accuracy was 95.17%, 94.48% and 89.04%, respectively. In addition, their true positive rates for all malaria species were 76.19%, 82.61% and 73.83%; for falciparum malaria 85.71%, 80.95% and 80.00%, and for vivax malaria 57.14%, 100% and 50%, respectively, with the parasitemia ranging from 80 to 58,240 microl of blood. Consequently, their costs were determined by dividing into provider and consumer costs, which were consequently classified into internal and external costs. The internal costs were the costs of the public providers, whereas the external costs were those incurred by the patients. The aggregate costs of these three models were 58,500.35, 36,685.91, and 40,714.01 Baht, respectively, or 339.53, 234.39, and 243.93, in terms of unit costs per actual case. In the case of microscopy, if all suspected malaria cases incurred forgone opportunity costs of waiting for treatment, the aggregate cost and unit cost per actual case were up to 188,110.89 and 944.03 Baht, respectively. Accordingly, the cost-effectiveness for all malaria species, using their true positive rates as the effectiveness indicator, was 446.75, 282.40, and 343.56 respectively, whereas for falciparum malaria it was 394.80, 289.37 and 304.91, and for vivax malaria 595.67, 234.39 and 487.86, respectively. This study revealed that the on-site OptiMAL was the most cost-effective. It could be used to supplement or even replace microscopy for this criteria in general. This study would be of benefit to malaria control program policy makers to consider using RDT technology to supplement microscopy in remote non-microscope areas.

Chromatography↗
PubMed1974

Mathematical analysis of the API enteric 20 profile register using a computer diagnostic model.

Results for 21 biochemical tests using the API-20 Enteric kit were obtained from the manufacturer's files for 27,820 bacterial isolates. These isolates were identified by the API Profile Register and also by a computer diagnostic model which estimates the relative likelihoods of various identifications. The computer confirmed the identification in the API Profile Register for 99.36% of the isolates. The manufacturer has reviewed areas of the API Profile Register questioned by the computer analysis; a number of resulting modifications to the API Profile Register have been incorporated in an update letter. This computer model provides a convenient and powerful way to interpret a large number of test results for bacterial identification. This study also demonstrates the use of a large collection of isolates to refine the data matrix used by the diagnostic model.

Bacteriological Techniques↗
PubMed1986

Acoustic neurinoma diagnostic model evaluation using decision support systems.

Three acoustic neurinoma (hereafter called acoustic neuroma) diagnostic models (Jenkins, Le Liever, Kaseff) were implemented as rule-based decision support systems and evaluated from the perspective of sensitivity, specificity, and US dollar cost, using a data base of 95 case histories suggestive of acoustic neuroma. The specificities of the models were equivalent (.97). The Jenkins model had the highest sensitivity (.96) and the highest average cost ($1470.99). The sensitivities and average costs of the Le Liever and Kaseff models were comparable (.84 vs. .82, and $1092.38 vs $1114.17, respectively). We observed that omitting brain-stem evoked response and electronystagmography testing from the Le Liever model subjected four (4.2%) more patients without acoustic neuroma to air contrast computed tomography, increased sensitivity to .89, and decreased the average cost to $774.75, without affecting specificity. We discuss the reasons for the slightly improved sensitivity and the impact of decision support systems on the clinician.

Decision Making↗
PubMed2005

Diagnostic model for sensitization in workers exposed to occupational high molecular weight allergens.

BACKGROUND: Occupational allergy has great impact on workers exposed to high molecular weight (HMW) allergens. The present study is aimed to develop and validate a generic diagnostic model for sensitization to HMW allergens, defined as positive IgE. METHODS: The model was developed in pooled data from Dutch laboratory animal (LA) workers and bakers using logistic regression analysis. Validity was assessed internally by bootstrapping procedure, and externally in British LA workers. RESULTS: The model included working hours/week, work-related symptoms, total IgE, and IgE to common allergen. Significant interactions between the type of work and the predictors resulted in different scores for LA workers and bakers. Internal and external validation showed that the model was satisfactorily calibrated and discriminated between workers at high and low risk of being sensitized. CONCLUSIONS: It is possible to develop a generic model for sensitization to occupational HMW allergens. However, the weighing of predictors differs across specific work environments.

Adult↗
PubMedDate not supplied

[The construction of a diagnostic model for the differentiation of resident and transient staphylococcal microflora in bacterial carriage].

The comparative analysis of 16 biological characteristics of staphylococci isolated from specially selected groups of persons with different types of carrier state has been made. Five signs (antilysozyme, anti-interferon and anticomplementary activities, sensitivity to fusidin, microbial contamination) forming the main informative combination have been determined. The diagnostic model of the differentiation of resident and transitory staphylococcal microflora in carrier state has been developed.

Carrier State↗
PubMed1992

Diagnostic model for local temporal thermal change at the skin of the breast during extended application of diagnostic ultrasound.

A biophysical model is derived to account for the temporal thermal change at the skin of the breast as a result of ultrasound stimulation at the suspect lesion for seven minutes, with responses recorded using an infrared camera. Twenty-two patients were studied. The observed temporal responses for malignant cases have a different pattern from those of the benign cases studied and a mathematical model is used to investigate the controlling parameters. A new method is used to estimate the coefficients of the resulting difference equation which allows more useful diagnostic parameters to be computed than the corresponding continuous bioheat equation. The model is used to fit the experimental data. The results suggest that this method might be a rapid and noninvasive aid for distinguishing between benign and malignant breast tumours.

Biophysical Phenomena↗
PubMed2001

Reference data and predictive diagnostic models for calcaneus bone mineral density measured with single-energy X-ray absorptiometry in 7428 Chinese.

Calcaneus bone mineral density (BMD) of 7428 Chinese (4126 women, 3302 men; aged 22-94 years) was measured using single-energy X-ray absorptiometry (SXA). A reference range of calcaneus BMD values for healthy Chinese men and women was established and the usefulness of this method for screening and diagnosis in osteoporosis was evaluated. The peak BMD occurred at 20-24 years old and peak BMD in women was significantly lower than in men. BMD loss in the calcaneus started at the age of 35 years for women, and at 63 years in men. BMD loss rate was 1.2%/year for women and 0.56%/year for men after 50 years. The young normal reference for calcaneus BMD was 442.1+/-69.6 mg/cm2 for men and 388.3+/-61.7 mg/cm2 for women calculated from the mean BMD value of subjects whose age ranged from 20 to 49 years. The accumulated BMD loss in the calcaneus is similar to that of Ward's triangle. Multiple linear regression showed that both age and weight were important factors. The incidence of osteoporosis in older men and women (> or = 60 years) is 6.6% and 32.1% respectively. We conclude that calcaneus BMD measurement is useful and sensitive for the screening and diagnosis of osteoporosis. A predictive diagnostic model for osteoporosis based on the calcaneus was constructed using multiple linear regression and the WHO criteria for diagnosing osteoporosis can be applied to calcaneus BMD.

Absorptiometry, Photon↗
PubMedDate not supplied

Modeling diagnostic reasoning: a summary of parsimonious covering theory.

Parsimonious covering theory is a formal model of diagnostic reasoning. Diagnostic knowledge is represented in the theory as a network of causal associations, and problem-solving is represented in algorithms that support a hypothesize-and-test inference process. This paper summarizes in informal terms the basic ideas in parsimonious covering theory.

Algorithms↗
PubMed2003

Non-invasive diagnosis of coronary artery disease by quantitative stress echocardiography: optimal diagnostic models using off-line tissue Doppler in the MYDISE study.

AIMS: To develop optimal methods for the objective non-invasive diagnosis of coronary artery disease, using myocardial Doppler velocities during dobutamine stress echocardiography. METHODS AND RESULTS: We acquired tissue Doppler digital data during dobutamine stress in 289 subjects, and measured myocardial responses by off-line analysis of 11 left ventricular segments. Diagnostic criteria developed by comparing 92 normal subjects with 48 patients with coronary disease were refined in a prospective series of 149 patients referred with chest pain. Optimal diagnostic accuracy was achieved by logistic regression models, using systolic velocities at maximal stress in 7 myocardial segments, adjusting for independent correlations directly with heart rate and inversely with age and female gender (all p<0.001). Best cut-points from receiver-operator curves diagnosed left anterior descending, circumflex and right coronary disease with sensitivities and specificities of 80% and 80%, 91% and 80%, and 93% and 82%, respectively. All models performed better than velocity cut-offs alone (p<0.001). CONCLUSION: Non-invasive diagnosis of coronary artery disease by quantitative stress echocardiography is best performed using diagnostic models based on segmental velocities at peak stress and adjusting for heart rate, and gender or age.

Adult↗