Is language an issue? Accuracy of the German computerized diagnostic decision support system ISABEL and cross-validation with the English counterpart.

Autor:	Marcin T; Department of Emergency Medicine, Inselspital University Hospital Bern, Bern, Switzerland., Lüthi A; Department of Emergency Medicine, Inselspital University Hospital Bern, Bern, Switzerland.; Faculty of Medicine, University of Bern, Bern, Switzerland., Graf RR; Department of Emergency Medicine, Inselspital University Hospital Bern, Bern, Switzerland.; Faculty of Medicine, University of Bern, Bern, Switzerland., Krummrey G; Department of Emergency Medicine, Inselspital University Hospital Bern, Bern, Switzerland., Schauber SK; Centre for Educational Measurement, Faculty of Educational Sciences, University of Oslo, Oslo, Norway.; Centre for Health Sciences Education, Faculty of Medicine, University of Oslo, Oslo, Norway., Breakey N; Department of Medicine, Spital Emmental, Burgdorf, Switzerland., Hautz WE; Department of Emergency Medicine, Inselspital University Hospital Bern, Bern, Switzerland., Hautz SC; Department of Emergency Medicine, Inselspital University Hospital Bern, Bern, Switzerland.
Jazyk:	angličtina
Zdroj:	Diagnosis (Berlin, Germany) [Diagnosis (Berl)] 2023 Jul 24; Vol. 10 (4), pp. 398-405. Date of Electronic Publication: 2023 Jul 24 (Print Publication: 2023).
DOI:	10.1515/dx-2023-0047
Abstrakt:	Objectives: Existing computerized diagnostic decision support tools (CDDS) accurately return possible differential diagnoses (DDx) based on the clinical information provided. The German versions of the CDDS tools for clinicians (Isabel Pro) and patients (Isabel Symptom Checker) from ISABEL Healthcare have not been validated yet. Methods: We entered clinical features of 50 patient vignettes taken from an emergency medical text book and 50 real cases with a confirmed diagnosis derived from the electronic health record (EHR) of a large academic Swiss emergency room into the German versions of Isabel Pro and Isabel Symptom Checker. We analysed the proportion of DDx lists that included the correct diagnosis. Results: Isabel Pro and Symptom Checker provided the correct diagnosis in 82 and 71 % of the cases, respectively. Overall, the correct diagnosis was ranked in 71 , 61 and 37 % of the cases within the top 20, 10 and 3 of the provided DDx when using Isabel Pro. In general, accuracy was higher with vignettes than ED cases, i.e. listed the correct diagnosis more often (non-significant) and ranked the diagnosis significantly more often within the top 20, 10 and 3. On average, 38 ± 4.5 DDx were provided by Isabel Pro and Symptom Checker. Conclusions: The German versions of Isabel achieved a somewhat lower accuracy compared to previous studies of the English version. The accuracy decreases substantially when the position in the suggested DDx list is taken into account. Whether Isabel Pro is accurate enough to improve diagnostic quality in clinical ED routine needs further investigation. (© 2023 the author(s), published by De Gruyter, Berlin/Boston.)
Databáze:	MEDLINE
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