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Computerised triage in a prostate assessment clinic.
G N Rajkumar1, D R Small, I G Conn
1Department of Urology, Southern General Hospital, Glasgow, UK. radhraj@hotmail.com
Prostate Cancer and Prostatic Diseases
|June 4, 2004
Summary
A new software package aids prostate outpatient management by scoring International Prostate Symptom Score (IPSS) and patient history. It shows promise, though uroflow results require further refinement.
Area of Science:
- Urology
- Health Informatics
- Medical Software Development
Background:
- Effective management of prostate outpatients requires accurate assessment of symptoms, history, and laboratory results.
- Current clinical workflows can be time-consuming and may benefit from automated decision support systems.
- Standardized scoring systems like the International Prostate Symptom Score (IPSS) are crucial for consistent evaluation.
Purpose of the Study:
- To develop and evaluate a user-friendly MS Office package for scoring IPSS, patient history, and guiding interim management in prostate outpatients.
- To compare computer-generated management decisions with those of a consultant urologist.
- To assess the system's potential for improving efficiency and accuracy in outpatient urological care.
Main Methods:
- Development of an MS Office package using Excel and Visual Basic for data input (IPSS, history, lab results) and management rule implementation.
- Patient interaction via a touch screen for IPSS and medical history input, stored in Excel spreadsheets.
- Comparison of computer-driven management decisions against a consultant urologist's decisions for 139 patients.
Main Results:
- The system achieved agreement with consultant urologist decisions in 106 out of 139 patients (76%).
- Disagreements (33 patients) were primarily due to the computer's oversensitivity to uroflow results (21 cases).
- In 12 cases, the urologist deviated from the system's rules when single variables were slightly abnormal.
Conclusions:
- The developed software system demonstrates significant potential for user-friendly management of prostate outpatients.
- The system effectively integrates patient data and established management rules to support clinical decision-making.
- Further refinement, particularly regarding uroflowmetry interpretation, is needed to optimize performance, with artificial neural networks being investigated.
