Effectiveness of the Quick Medical Reference as a diagnostic tool

A NUMBER OF COMPUTER-BASED SYSTEMS With diagnostic capabilities have been d eveloped for internal medicine. Quick Medical Reference (QMR) is one such p rogram. The authors describe key features of QMR and report on their study of its effectiveness as a diagnostic toot. They investigated how frequently the correct diagnosis would appear among the 5 highest ranked diagnoses ge nerated by QMR. The charts of 1144 consecutive patients admitted to a teach ing unit were retrospectively screened. Eligible cases included those refer red for investigation of an undiagnosed illness with an objectively proven final diagnosis (n = 154). Two physicians familiar with, but not experts in , the use of QMR entered clinical information abstracted from the patients' charts into the program. Physician A obtained the correct diagnosis in 62 (40%) of the 154 cases, and physician B was successful in 56 (36%) of the c ases. The authors use study cases to illustrate QMR's strengths and weaknes ses.