PRESENT STATE EXAMINATION BY MICROCOMPUTER - OBJECTIVES AND EXPERIENCE OF PRELIMINARY STEPS

A three-year interdisciplinary medical expert system software design p roject and its clinical evaluation is described. The aim was to teach a computer to conduct a simplified clinical Present State Examination (SCAN, PSE-IO; Wing et al., 1990) to elicit and judge the presence of symptoms of anxiety and depression in psychiatric patients. In a relia bility study on 29 non-psychotic psychiatric in-patients, unacceptably low reliability was found for the presence of symptoms and diagnoses (ICD-10 F3 and F4) in a comparison between a clinician and a computer administered SCAN assessment. Modest reliability for symptom scores wa s found. Possible directions for progress in the future are discussed in the light of the immediate conclusion that only a trained person ca n conduct a reliable clinical Present State Examination.