[Evaluation of clinical-pathological conferences using a program for computer-assisted diagnosis; analysis of 100...

Case studies as weekly published in the New England Journal of Medicine are analysed using the computer programme Medwise. The programme covers more than 3,500 disease profiles. After entering clinical data on all patients described in 1986 and 1987, the diagnostic outcome was compared with the results of the clinicians and with the eventual patho-anatomical findings. Medwise gave the correct diagnosis in 93% of the 104 cases considered. In 15 cases the clinicians failed to formulate the patho-anatomical diagnosis; Medwise correctly detected nine of these (60%). Medwise missed the diagnosis in seven cases, but the clinicians' answers were also faulty in six of them. These results indicate the usefulness of computer-assisted interpretation of clinical findings for establishing the diagnosis, provided that the course and laboratory data concerning the patient are accurately documented.