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Artificial Intelligence: Bayesian versus Heuristic Method for Diagnostic Decision Support.

Peter L Elkin1, Daniel R Schlegel1, Michael Anderson2

  • 1Department of Biomedical Informatics, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, New York, United States.

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Biomedical informatics developed an expert system for knee problem self-diagnosis. Specificity (Sp) in the Disease-times-Term Importance model proved superior for patient referral compared to Evoking Strength (ES).

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Area of Science:

  • Biomedical Informatics
  • Artificial Intelligence
  • Orthopedics

Background:

  • Biomedical informatics contributes to Artificial Intelligence through expert systems.
  • The University at Buffalo's Orthopedics Department aimed to develop a knee problem diagnostic expert system.
  • The system facilitates patient self-diagnosis and referral to orthopedic subspecialists.

Purpose of the Study:

  • To create an expert system for knee problem self-diagnosis and specialist referral.
  • To compare the diagnostic accuracy of Specificity (Sp) versus Evoking Strength (ES) in an expert system.
  • To evaluate the effectiveness of Sp and ES in patient referral assignment.

Main Methods:

  • Two sports medicine physicians reviewed 469 knee problem cases.
  • A senior practitioner resolved disagreements to establish a gold standard diagnosis.
  • Patients entered data via a web interface; findings were modeled and reviewed, assigning Sp and ES values.

Main Results:

  • The Disease-times-Term Importance (DItimesTI) model using Sp showed superior accuracy for patient referral compared to ES (p<0.0001).
  • The advantage of Sp over ES for referral assignment diminished after the fifth diagnosis.
  • No significant difference was observed between Sp and ES when used as a reminder system.

Conclusions:

  • The DItimesTI model incorporating Sp enhances the accuracy of patient referral for knee conditions.
  • Evoking Strength (ES) is less effective than Sp for specialist referral in this expert system.
  • The utility of both Sp and ES is comparable for diagnostic reminder functions.