EVALUATION OF EPILEPSY EXPERT - A DECISION-SUPPORT SYSTEM

Epilepsy Expert is a decision support system based on the Internationa l Classification of Epilepsies and Epileptic Syndromes (1989). The aim of this study was to evaluate the Epilepsy Expert. First the diagnost ic performance was validated. This was done in 3 stages: collection of the patient cases, determination of the 'correct diagnoses' and testi ng the system. How the users perceived the functionality of the system was studied by using an inquiry. Three physicians, experts of epileps y, from different hospitals were asked to choose 10 patients. In the p atient description was a short history, a detailed description of the seizure, EEG findings and their own diagnosis. Next, each expert made a diagnosis of the cases supplied by other experts by using the Intern ational Classification of Epilepsies and Epileptic Syndromes. The 'cor rect diagnosis' (so-called majority agreement) was the diagnosis given by the majority of the experts. The diagnosis of each expert was comp ared with the 'correct diagnoses'. In the evaluation the expert physic ians agreed on 37% of cases and all 3 disagreed on 17%. A majority agr eed on 25 cases, which were used in the evaluation. In these 25 cases the experts' (A,B,C) diagnoses were correct or partly correct in 100, 64, 80% of cases, respectively. The program's diagnoses were correct o r partly correct in 80% (module I) and 76% (modules IV and V) of cases . In the evaluation Epilepsy Expert was found to be only partly succes sful. The main reason for this was the weakness of the international c lassification. However, the program seems to be very close to the leve l of the experts. According to this limited inquiry Epilepsy Expert is not suitable for clinical use, because it is, for example, too simple and does not contain enough information.