AI systems in clinical practice

Decision support systems
DXplain
Diagnostic decision support system for general medicine

developed by clinical domains keywords
Lab. of Computer Science, Massachusetts General Hospital general medicine, diagnosis, medical education deicison support system
location commissioned status
Massachusetts General Hospital and others 1987 In educational and clinical use
description
DXplain logo DXplain is a decision support system which acts on a set of clinical findings (signs, symptoms, laboratory data) to produce a ranked list of diagnoses which might explain (or be associated with) the clinical manifestations. DXplain provides justification for why each of these diseases might be considered, suggests what further clinical information would be useful to collect for each disease, and lists what clinical manifestations, if any, would be unusual or atypical for each of the specific diseases. DXplain does not offer definitive medical consultation and should not be used as a substitute for physician diagnostic decision making.

DXplain takes advantage of a large data base of the crude probabilities of over 4500 clinical manifestations associated with over 2000 different diseases. The system uses a modified form of Bayesian logic. It was developed at the Massachusetts General Hospital over ten years ago and has been used by thousands of users since then, both as a stand-alone version and over the Internet. The database and the system is continually being improved and adapted as a result of comments from the users. DXplain is in routine use at a number of hospitals and medical schools mostly for clinical education but also for clinical consultation.

DXplain has the characteristics of both an electronic medical textbook and a medical reference system. In the role of a medical textbook, DXplain can provide a comprehensive description of over 2,000 different diseases, emphasizing the signs and symptoms that occur in each disease, the etiology, the pathology, and the prognosis. DXplain also provides up to 10 recent references that have been selected as being appropriate reference material for each specific disease. In addition, DXplain can provide a list of diseases which should be considered for any one of over 5,000 different clinical manifestations (signs, symptoms, and laboraory examinations).

DXplain is owned by Massachusetts General Hospital. A web-enabled version of DXplain, providing unlimited Internet access for a modest royalty is now available to medical schools and hospitals. Mass Gen Hosp can be contacted for information about the license.

The standalone version of the software is no longer distributed.

references
Barnett GO, Famiglietti KT, Kim RJ, Hoffer EP, Feldman MJ. DXplain on the Internet, Proc AMIA Symp 1998;:607-11.

[PubMed]  

" "
Elhanan G, Socratous SA, Cimino JJ. Integrating DXplain into a clinical information system using the World Wide Web. Proc AMIA Annu Fall Symp. 1996;:348-52.

[PubMed]  

" "
Barnett GO, Hoffer EP, Packer MS, DXplain-demonstration and discussion of a diagnostic decision support system. Proc Annu Symp Comput Appl Med Care. 1992;:822. " "

Feldman MJ, Barnett GO. An approach to evaluating the accuracy of DXplain. Comput Methods Programs Biomed. 1991 Aug;35(4):261-6. " "

Barnett GO, Cimino JJ, Hupp JA, Hoffer EP. DXplain. An evolving diagnostic decision-support system. JAMA. 1987 Jul 3;258(1):67-74. " "

contact links

Octo Barnett
Laboratory of Computer Science
Massachusetts General Hospital
Harvard Medical School.

E: Barnett.Octoatmgh.harvard.edu

 bullet  DXplain (Mass Gen Hosp)  bullet  DXplain license information (Mass Gen Hosp)  bullet  Laboratory of Computer Science, Massachusetts General Hospital  bullet  DXplain [OC demonstrators section]
acknowledgements

Archive of AI systems in clinical practice previously administered by Enrico Coiera. Used with permission. Maintained and extended since 2001 by OpenClinical.

Entry on archive: November 7 1995
Last updated: September 30 2002
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