Evaluation of HepatoConsult, a computer-assisted expert system for the diagnosis of liver disease: preliminary results and trends

Background and objective: HepatoConsult (HC) is a medical expert system, ba sed on the expert system building block D3, designed to aid in the diagnosi s of liver and biliary tract disease. It was the aim of this study to evalu ate its diagnostic competence in clinical cases prospectively. Patients and methods: The diagnostic accuracy of HC was tested prospectivel y in 106 consecutive patients with the main diagnosis of liver disease. 57 were ambulant, 49 were in-patients. The data were obtained and stored at de fined phases of the diagnosis. The diagnoses put forward by HC were compare d with the final clinical diagnosis and, on the basis of the data, checked for plausibility by four experienced physicians. Results: After history taking and physical examination HC put forward the m ain diagnosis, as established by the doctors in charge, in 60% of patients. After addition of the results of basic laboratory tests and sonography, HC provided the correct diagnosis in 85% and, after inclusion of all the find ings, in 93%. In almost all cases HC put forward diagnoses that were, on th e basis of the supplied data, considered correct by the four physicians exp erienced in liver disease. In 56% of cases HC provided more differentiated diagnoses or items in the differential diagnosis than the attending doctors . In the opinion of the four assessors HC had not put forward any seriously wrong diagnoses. Conclusion: HC can be useful in solving diagnostic problems and thus in ens uring the quality of medical diagnoses.