TOXOPERT-I - KNOWLEDGE-BASED AUTOMATIC INTERPRETATION OF SEROLOGICAL TESTS FOR TOXOPLASMOSIS

Primary infection with Toxoplasma gondii, a parasite found in most reg ions of the world, is asymptomatic in more than 80% of cases. However, primary infection with Toxoplasma gondii in a pregnant woman might ca use fetal infection and severe damage. Most cases do not require treat ment. This applies to women without any infection (denoted as seronega tive) and women who have acquired the infection before conception (den oted as latent). In contrast, women with postconceptual infection requ ire immediate treatment to prevent or ameliorate fetal infection. We h ave developed an expert system, called TOXOPERT-I, designed for routin e laboratory work, which automatically interprets serological test res ults of toxoplasma infection. By using the system the clinician can al so examine questionable cases by interactively exploring possible resu lts. We used a popular method of designing expert systems applied to m edical interpretation and therapy advice, the rule-based one. In order to meet the requirements of automatic interpretation in toxoplasma se rology the following characteristics were introduced: the interpretati on of sequences of test results, the possibility of excluding inconsis tent test results and the adaptability of the knowledge base. A decisi on graph that covers the different kinds of infections as well as ther apy and recommendations for further tests was designed, implemented an d was clinically tested by carrying out a retrospective study includin g 1000 pregnant women. A comparison of TOXOPERT-I and the clinician's interpretations yielded sensitivity and specificity rates of over 99% each. (C) 1997 Elsevier Science Ireland Ltd.