Automated diagnostic systems

Sarbadhikari, SN (2004) Automated diagnostic systems. Indian Journal of Medical Informatics, 1 (1). pp. 25-28.

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Abstract

Reaching a foolproof diagnosis is never an easy job for a clinician. Often, a simple diagnostic procedure or test is overlooked and the disease eludes diagnosis. Clinical reasoning and decision making are phased. Initially there is a clinical evaluation (history taking and physical examination), followed by precise laboratory investigations. Then integration of clinical findings and test results is done. After that, comparative benefits and risks are weighed among the alternative courses of actions, like drug interactions. Finally, the patient's preferences are taken into account, along with ethical and other considerations like cost of therapy, compliance expectations and a therapeutic plan is developed. Right from the first step (history taking) to the final one, computers can be of immense help to the clinician. CDSS (Clinical or Diagnostic Decision Support Systems) are Interactive computer programs, which directly assist physicians and other health professionals with decision making tasks. I have the pleasure of developing some diagnostic decision support systems for medical education and research. Intuitive thought processes involve rapid unconscious data processing and combines available information by law of average and therefore, has a low intra- and inter-person consistency. So, the clinician of today should move towards analytic decision making, which albeit typically slow, is conscious, consistent and clearly spells out the basis of decision. Nevertheless, for computer-assisted diagnostic systems, a human clinician ("man in the loop" for "Intelligence Amplification") must be a necessary component. Moreover, the clinician must understand completely the strengths and limitations of them. Computerized diagnostics and clinical acumen are not mutually exclusive; rather they should reinforce each other for the alleviation of psychosomatic or rather 'psycho-bio-social' suffering of mankind. However, with sophisticated gadgetry taking the upper hand, the "human touch" should not be overlooked or forgotten.

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