Use of computers in diagnosis of jaundice

The development of computer-assisted diagnostic systems for the differential diagnosis of jaundice has been attempted in several studies during the last 25-30 years. All working systems have depended on numerical methods whereas expert systems have not yet become operational. The first step in the construction of a system is the collection of a data base from a series of jaundiced patients of clinical information (indicants) i.e. symptoms, signs, and the results from laboratory tests. The best discriminating indicants are selected and processed into a mathematical rule. The performance of this rule must be tested on an independent test sample of relevant patients. The performance may also be compared to that of clinicians. So far the computerized diagnoses have not been more accurate than those of clinicians. However, computer-assisted diagnostics may form an important first step in clinical decision making regarding the selection of a confirmatory diagnostic test (direct cholangiography, ultrasonography, liver biopsy, etc.) in the evaluation of the jaundiced patient.