What if your doctor was right 98% of the time in his or her differential diagnosis? A genius? Perhaps our expectation is that our doctor should score 100%, but that would not only be “aggressive,” it would be wildly inaccurate – after all doctors are human. That begs the question of the likely future use of medical clinical algorithm’s to aid in the improvement of medical diagnosis. Medical Clinical Algorithms’ incorporate a method of using medical tests such as The Oxford Text Book of Medicine and hundreds of medical journal articles into a differential diagnosis decision tree model to computer diagnose an illness through the symptom presented by a patient.
The reasons for missed diagnoses are many and varied. They include carelessness, over confidence, complacency, miscommunication, distraction, fatigue, and premature closure in analysis. New web-based diagnosis enhancement systems which interface with electronic medical records or with electronic hand-held devices are currently in use to back-up physician diagnosis. Systems such as Isabel Healthcare of (Isabelhealthcare.com) are reported to have identified the correct diagnosis 98% of the time. “Isabel” by the way is the young daughter of the systems’ designer Jason Maude, who developed the system after his daughter nearly died following a missed diagnosis of two simultaneous medical conditions at St. Mary’s Hospital in London, England. Dr. Joseph Britto, the Company’s Medical Director describes the Isabel system as a “google” built for Medicine.
Like Google, Isabel is fast-becoming a verb. (“Have you Isabeled that patient yet.”)
Despite its growing use, Isabel has room for improvement. For example, it is presently unable to prioritize its selection of diagnoses on the basis of probability. It promises sort-of a check list of analytical diagnoses to choose form starting initially with a list of ten and adding more further on. (There are over 10,000 known medical conditions to choose from.)
Given the probable improvement in features and sophistication of its algorithms and the economics of medicine, Isabel and similar systems are likely to leapfrog in the future from failsafe back-up systems to the principal diagnostic mechanism in use. Consider the prospect of a medical practice where an enterprising physician or group of physicians utilize Isabel to perform most of their diagnoses analyses and prescription recommendations. Trained, but lower-paid attendants assemble the symptoms and feed them into the Isabel system, with only the paper work to be reviewed by the physician, except in those rare sets of circumstances when the physician needs to call upon his or her intuition rather than science as an aid to diagnosis. Physicians would be able to undertake the care of many more patients at lower cost, faster flow-through and greater accuracy. The future of medicine will be different for both doctors and patients.
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