AI systems in clinical practice

Laboratory systems
Austria - Österreich   Hepaxpert III / WWW
Knowledge-based analysis and interpretation of serologic tests for hepatitis A, B, C and D

developed by clinical domains keywords
Department of Medical Computer Sciences, University of Vienna and the University Clinic of Gastroenterology and Hepatology. Hepatitis A, B, C, and D serologic tests, Laboratory Medical expert system; Laboratory interpretive system, quality assurance
location commissioned status
HEPAXPERT-I and HEPAXPERT-II have been routinely used at the Vienna General Hospital, the teaching hospital of the University of Vienna Medical School. 1989 (Hepaxpert I); 1991 (Hepaxpert II); 1998 (Hepaxpert III / WWW)
description
HEPAXPERT-III is the successor of HEPAXPERT-I and HEPAXPERT-II. It is an integrated medical database and knowledge-based system that stores and interprets the results of serologic tests for infection with hepatitis A, B, C, and D viruses.

HEPAXPERT-III provides the following functions: a) screen input of patient's personal data (patient ID, surname, first name, name at birth, date of birth, and sex), administrative data (department requiring the tests and date of specimen sample), and medical data (results of serologic tests); and/or b) automatic transfer of patient's personal, administrative, and medical data by connecting HEPAXPERT-III to a laboratory information system, a hospital information system, or an automated laboratory analyzer; and c) automatic generation of interpretive reports of the obtained serologic findings, including an analysis of possible virus exposition, immunity, disease stage, prognosis, and degree of infectiousness.

Hepaxpert I is a stand alone program with no direct connection to an external data source. Hepaxpert II is a database and interpretive system providing database management and download functions as well.It can be connected directly to a laboratory information system, a hospital information system or an automated laboratory analyzer. Hepaxpert III is a WWW implementation of Hepaxpert.

references

Chizzali-Bonfadin C, Adlassnig KP, Kreihsl M, Hatvan A, Horak W. A WWW-accessible knowledge base for the interpretation of hepatitis serologic tests. Int J Med Inform. 1997 Nov;47(1-2):57-60.

[PubMed]   []

" HEPAXPERT is a knowledge-based system that interprets the results of routine serologic tests for infection with hepatitis A and B viruses. The following tests are included: hepatitis A virus anti-bodies (anti-HAV), IgM antibodies to the hepatitis A virus (IgM anti-HAV), hepatitis A virus (HAV in stool, hepatitis B surface antigen (HBsAg) and antibodies (qualitative anti-HBs, quantitative anti-HBs titre), antibodies to hepatitis B core antigen (anti-HBc and IgM anti-HBc), and hepatitis B envelope antigen (HBeAg) and antibodies (anti-HBe). HEPAXPERT/WWW--an implementation of HEPAXPERT-III for WWW--can be reached by URL http://www.swun.com/hepax of the World Wide Web. After selecting HEPAXPERT/WWW, serologic test results can be entered and will be transferred as an e-mail message for subsequent interpretation which is done off-line with HEPAXPERT-III. The textual interpretation is sent back via e-mail. Each qualitative test for hepatitis A and B antibodies and antigens may produce one of four possible results: positive, negative, borderline, and not tested. To cover the resulting 64 (A) and 57344 (B) combinations of findings, the knowledge base of HEPAXPERT/WWW contains 16 rules for hepatitis A and 131 rules for hepatitis B serology interpretation. This basic knowledge is structured such that all possible combinations of findings can be interpreted and there is no overlap in the premises underlying the rules. The reports that the system automatically generates include: (a) the transferred results of the tests; (b) a detailed analysis of the results, including virus exposure, immunity, stage of illness, prognosis, infectiousness, and vaccination recommendation; and (c) optional: an ID to distinguish the origin of the interpretation requests. "

Chizzali-Bonfadin C, Adlassnig KP, Kreihsl M, Hatvan A, Horak W. Knowledge-based interpretation of serologic tests for hepatitis on the World Wide Web. Clin Perform Qual Health Care 1997 Apr-Jun;5(2):61-3

[PubMed]
" HEPAXPERT is a knowledge-based system that interprets the results of routine serologic tests for infection with hepatitis A and B viruses. The following tests are included: hepatitis A virus antibodies, IgM antibodies to the hepatitis A virus, hepatitis A virus in stool, hepatitis B surface antigen and antibodies, antibodies to hepatitis B core antigen, and hepatitis B envelope antigen and antibodies. HEPAXPERT/WWW, an implementation of HEPAXPERT-III for the World Wide Web, can be reached by URL http://www.med-expert.co.at/hepax. After selecting HEPAXPERT/WWW, serologic test results can be entered and will be transferred as an E-mail message for subsequent interpretation, which is done off-line with HEPAXPERT-III. The textual interpretation is sent back via E-mail. Each qualitative test for hepatitis A and B antibodies and antigens may produce one of four possible results: positive, negative, borderline, and not tested. To cover the resulting 64 (A) and 57,344 (B) combinations of findings, the knowledge base of HEPAXPERT/WWW contains 16 rules of hepatitis A and 131 rules for hepatitis B serology interpretation. This basic knowledge is structured such that all possible combinations of findings can be interpreted, and there is no overlap in the premises underlying the rules. The reports that the system automatically generates include the transferred results of the tests; a detailed analysis of the results, including virus exposure, immunity, stage of illness, prognosis, infectiousness, and vaccination recommendation; and, as an option, an identification, to distinguish the origin of the interpretation requests. "

Adlassnig KP, Chizzali-Bonfadin C, Kreihsl M, Schulz F, Horak W, Hofmann H. HEPAXPERT-III: knowledge-based interpretation of serologic tests for hepatitis A, B, C, and D Medinfo 1995;8 Pt 2:1683.

[PubMed]

" The HEPAXPERT-III SYSTEM. HEPAXPERT-III--the successor of HEPAXPERT-I[1] and HEPAXPERT-II [2]--is a routinely-used, integrated medical database and knowledge-based system that stores and interprets the results of serologic tests for infection with hepatitis A, B, C, and D viruses. The following tests are included: Anti-HAV, IGM anti-HAV, and HAV in stool; HBsAg, anti-HBs, anti-HBc, IGM anti-HBc, HBeAg, anti-HBe, and anti-HBs titre; Anti-HCV, HCV-immunoblot, and HCV-PCR; Delta-Ag and anti-delta. HEPAXPERT-III provides the following functions: a) screen input of patient's personal data (patient ID, surname, first name, name at birth, date of birth, and sex), administrative data (department requiring the tests and date of specimen sample), and medical data (results of serologic tests); and/or b) automatic transfer of patient's personal, administrative, and medical data by connecting HEPAXPERT-III to a laboratory information system, a hospital information system, or an automated laboratory analyzer; and c) automatic generation of interpretive reports of the obtained serologic findings, including an analysis of possible virus exposition, immunity, disease stage, prognosis, and degree of infectiousness. HEPAXPERT-I and HEPAXPERT-II have been routinely used at the Vienna General Hospital, the teaching hospital of the University of Vienna Medical School. The interpretive reports are well-accepted and lead to several improvements in patient care [3]. HEPAXPERT-III will not only extend the scope of interpretation to hepatitis C and D serologic tests, but will also offer a state-of-the-art graphical user interface. 2. HARDWARE AND SOFTWARE. IBM-compatible personal computer (minimum 80386 SX processor), 8 MB RAM (OS/2) and 4 RM RAM (MS-Windows), resp., graphic adapter (minimum 640x480) and printer supported by OS/2 and MS-Windows 3.1, resp., IBM OS/2-2.1 or higher and MS-Windows 3.1 or higher, resp., and for the OS/2 version IBM Database 2 (DB2/2). "

Adlassnig KP, Horak W. Development and retrospective evaluation of Hepaxpert-I: a routinely-used expert system for interpretive analysis of hepatitis A and B serologic findings. Artif Intell Med. 1995 Feb;7(1):1-24.

[PubMed]   [ScienceDirect]

" Hepaxpert-I is an expert system that interprets the results of routine serologic tests for infection with hepatitis A or B virus. The tests measure antibody to the hepatitis A virus (anti-HAV), IgM antibody to the hepatitis A virus (IgM anti-HAV), hepatitis A virus (HAV) in the stool, hepatitis B surface antigen (HBsAg) and antibody (anti-HBs), antibody to hepatitis B core antigen (anti-HBc and IgM anti-HBc), and hepatitis B envelope antigen (HBeAg) and antibody (anti-HBe). The knowledge base of Hepaxpert-I contains 13 If-Then rules for hepatitis A and 106 If-Then rules for hepatitis B serology. Formally, knowledge acquisition was done by forming a partition of each of the two sets of possible serologic finding patterns that contain patterns of serologic test results, 64 for hepatitis A and 4096 for hepatitis B, respectively. After entering an input pattern of serologic test results in Hepaxpert-I, a rule pattern matching algorithm based on indexing is internally employed as efficient access method for providing the respective interpretive text. Since 1 September 1989, Hepaxpert-I has been routinely applied at the Hepatitis Serology Laboratory of the 2nd Department of Gastroenterology and Hepatology at the University of Vienna Medical School (Vienna General Hospital). Beforehand, a retrospective evaluation of the expert system based on 23,368 hepatitis A and 24,071 hepatitis B serology requests was carried out. "

Adlassnig KP, Horak W. Hepaxpert-1: Automatic interpretation of tests for hepatitis a and B. MD Comput 1991 Mar-Apr;8(2):118-9 " "
KP Adlassnig, W Horak, Routinely-used, automated interpretive analysis of hepatitis A and B serology findings by a medical expert system, Proc. Medical Informatic Europe `90, R. O'Moore et al. (eds), Lecture Notes in Medical Informatics, 40, Springer-Verlag, 313-318. " "

contact links

Prof. Klaus-Peter Adlassnig
Section on Medical Expert and Knowledge-Based Systems
Department of Medical Computer Sciences
Medical University of Vienna
Austria

 bullet  Demonstration and background information on HEPAXPERT III/WWW  bullet  Department of Medical Computer Sciences, University of Vienna
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: March 26 1993
Last main update: April 15 2002
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