Decision aid development for use in ambulatory health care settings

An approach is presented using interactive microcomputers for the development of diagnostic decision aids applicable to some complaints encountered in ambulatory care. The central feature of the descriptive phase of the approach is the use of the underlying (and perhaps dynamic) state of patient health. The central feature of the prescriptive phase of the approach is quick, simple assessment which produces a set of nondominated diagnostic tests, the selection of which is biased by the subjectively determined disease(s) that the diagnostician wishes to rule out or confirm. We present an application of the approach to the complaint, "diarrhea of recent onset in adults," discuss the hardware/software implementation, and summarize preliminary evaluation results.