RheumaTool, a novel clinical decision support system for the diagnosis of rheumatic diseases, and its first validation in a retrospective chart analysis.

Alder, Hannes; Marx, Christian; Steurer, Johann; Wertli, Maria; Korner-Nievergelt, Pius; Tamborrini, Giorgio; Langenegger, Thomas; Eichholzer, Andrina; Andor, Michael; Krebs, Andreas; Michel, Beat; Wildi, Lukas (2020). RheumaTool, a novel clinical decision support system for the diagnosis of rheumatic diseases, and its first validation in a retrospective chart analysis. Swiss medical weekly, 150(w20369), w20369. EMH Schweizerischer Ärzteverlag 10.4414/smw.2020.20369

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AIMS

RheumaTool is a clinical decision support system designed to support the diagnostic process in rheumatology by presenting a differential diagnosis list after the input of clinical information. The objective of this study was to evaluate the performance of RheumaTool in detecting the correct diagnosis in referrals to a rheumatology clinic.

METHODS

In this retrospective chart analysis, data were gathered from patients with musculoskeletal complaints and an uncertain diagnosis who were referred to a Swiss tertiary rheumatology outpatient clinic. Data were entered into RheumaTool in a standardised fashion, while the principal diagnoses in the medical reports were blinded. RheumaTool’s output was compared to the correct diagnoses, established either by widely accepted diagnostic criteria or through the expert consensus of independent rheumatologists. Diagnostic precision, the primary endpoint, was defined as the proportion of correctly diagnosed cases among all cases.

RESULTS

One hundred and sixty cases with 46 different diseases were included in this analysis. RheumaTool correctly diagnosed 40% (95% confidence interval 32.4–48.1) of all cases. In 63.8% (95% confidence interval 55.7–71.1), the correct diagnosis was present in a differential diagnosis list consisting of a median of two diagnoses.

CONCLUSION

In this first validation, RheumaTool provides a useful list of differential diagnoses. However, there is not sufficient diagnostic reliability for unfiltered data entry, especially in patients with multiple concomitant musculoskeletal disorders. This must be taken into account when using RheumaTool.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of General Internal Medicine (DAIM) > Clinic of General Internal Medicine

UniBE Contributor:

Wertli, Maria Monika

Subjects:

600 Technology > 610 Medicine & health

ISSN:

1424-7860

Publisher:

EMH Schweizerischer Ärzteverlag

Language:

English

Submitter:

Christine Baumgartner

Date Deposited:

22 Dec 2020 14:03

Last Modified:

30 Apr 2021 16:21

Publisher DOI:

10.4414/smw.2020.20369

PubMed ID:

33227823

BORIS DOI:

10.7892/boris.148786

URI:

https://boris.unibe.ch/id/eprint/148786

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