A model-based system to determine the relative value of different variables in a diagnostic system using Bayes...

A model system is described which simulates the presenting features of cases of vaginal discharge. This system was used to examine the effects of removing individual clinical features on the overall efficiency of diagnosis by Bayes theorem. The diagnostic efficiency was significantly reduced by elimination of inflammation, of a frothy discharge, or of a curdy discharge. Elimination of more than one significant factor further reduced the number of correct diagnoses, but elimination of more than one non-significant factor made no obvious difference. The most significant clinical feature was presence of inflammation; elimination of this feature had a substantial effect on the diagnosis of gardnerella, viral, gonorrhoea and foreign body. Elimination of two of the variables (bloodstaining and odour) which did not influence overall diagnostic efficiency nevertheless had a substantial effect on the diagnosis of neoplasms and foreign bodies. It is proposed that a simulation of this type is of potential practical value in determining a minimum subset of clinical features for diagnostic systems involving Bayes theorem.