AI systems in clinical practice

Decision support systems
QMR
Quick Medical Reference
Diagnostic decision-support system for internists

developed by clinical domains keywords
University of Pittsburgh; First DataBank, Inc., San Bruno, CA Multiple. Diagnosis, internists Medical knowledge base, medical reference, decision support, frame-based database
location commissioned status
Multiple locations 1980 Discontinued. No longer commercially available. Last known release in 2001.
description
Developed out of INTERNIST-I, Quick Medical Reference (QMR) is an in-depth information resource that helps physicians to diagnose adult diseases. It provides electronic access to more than 750 diseases representing the vast majority of the disorders seen by internists in daily practice as well a compendium of less common diseases.

QMR uses more than 5,000 clinical findings to describe the features of diseases in the QMR knowledge base. Findings include medical history, symptoms, physical signs, and laboratory test results. Laboratory test results are subdivided into three categories based on increasing levels of cost and invasiveness. QMR findings represent abnormal conditions, e.g., "Abdomen Pain Severe" or "Blood Hepatitis B Virus By Polymerase Chain Reaction."

Every disease profile included in the QMR knowledge base is the result of an extensive review of the primary medical literature. Consultation with experts is used to resolve any inconsistencies or deficiencies found in published reports. QMR is used in in-hospital and office practice.

Windows versions of QMR were available for single and multiple users; a hand-held version was under development and may have been released.

references

Lemaire JB, Schaefer JP, Martin LA, Faris P, Ainslie MD, Hull RD. Effectiveness of the Quick Medical Reference as a diagnostic tool. CMAJ. 1999 Sep 21;161(6):725-8.

[PubMed]   [CMAJ]

" A number of computer-based systems with diagnostic capabilities have been developed for internal medicine. Quick Medical Reference (QMR) is one such program. The authors describe key features of QMR and report on their study of its effectiveness as a diagnostic tool. They investigated how frequently the correct diagnosis would appear among the 5 highest ranked diagnoses generated by QMR. ... The authors use study cases to illustrate QMR's strengths and weaknesses. "

Friedman C, Elstein A, Worf F, Murphy G, Franz T, Heckerling P, Fine P, Miller T, Abraham V. Enhancement of clinicians' diagnostic reasoning by computer-based consultation: a multisite study of 2 systems. JAMA. 1999;282:1851-1856.

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Berner ES, Maisaik RS. Influence of case and physician characteristics on perceptions of decision support systems. J Am Med Inform Assoc. 1999;6:428-434

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Berner ES, Maisaik RS, Cobbs CG, Taunton OD. Effects of a decision support system on physicians' diagnostic performance. J Am Med Inform Assoc. 1999;6:420-427

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Arene I, Ahmed W, Fox M, Barr CE, Fisher K. Evaluation of quick medical reference (QMR) as a teaching tool. MD Comput. 1998;15:323-326

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Aliferis CF, Cooper GF, Miller RA, Buchanan BG, Bankowitz R, Giuse N. A temporal analysis of QMR. J Am Med Inform Assoc. 1996;3:79-91.

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Miller RA, Masarie FE Jr. Use of the Quick Medical Reference (QMR) program as a tool for medical education. Methods Inf Med. 1989;28:340-345.

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First MB, Soffer LJ, Miller RA. QUICK (QUick Index to Caduceus Knowledge): using the INTERNIST-1/CADUCEUS knowledge base as an electronic textbook of medicine. Comput Biomed Res. 1985;18:137-165.

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Masarie FE Jr, Miller RA, Myers JD. INTERNIST-I properties: representing common sense and good medical practice in a computerized medical knowledge base. Comput Biomed Res. 1985;18:458-479

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Miller RA, Pople HE Jr, Myers JD. Internist-1, an experimental computer-based diagnostic consultant for general internal medicine. N Engl J Med. 1982;307:468-476

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Ikechukwu A, Waseem A, Fox M et al. Evaluation of Quick Medical Reference (QMR) as a teaching tool. MD Comput 1998;15:323-6.

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contact links
N/A.

Discontinued as a First DataBank product.

 bullet  INTERNIST [OC]
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: February 8 2002
Last main updates: February 8 2002; February 10 2004
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