Abstract
Since primeval times, mankind has attempted to explain natural phenomena using models. For the past five decades, a new kind of modeler, the healthcare informatician, has developed and proliferated a new kind of model, the clinical Diagnostic Decision Support System (DDSS). This chapter presents a definition of clinical diagnosis and of DDSS; a discussion of how humans accomplish diagnosis; a survey of previous attempts to develop computer-based clinical diagnostic tools; a discussion of the problems encountered in developing, implementing, evaluating, and maintaining clinical diagnostic decision support systems; and a discussion of current and future systems.
Portions of this chapter have been taken verbatim, with permission of the American Medical Informatics Association (AMIA), which owns the copyrights, from: Miller RA, Medical Diagnostic Decision Support Systems—Past, Present, and Future: A Threaded Bibliography and Commentary. J Am Med Inform Assoc 1994;1:8–27; and from Miller RA, Evaluating Evaluations of Medical Diagnostic Systems, J Am Medical Inform Assoc 1996;3:429–431. Dr. Miller acknowledges the earlier contributions of Antoine Geissbuhler, MD, of the Hospital of the University of Geneva, Switzerland, who co-authored a previous version of this chapter. The author thanks Joyce Green for her assistance with copy editing.
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Notes
- 1.
In this chapter, R-QMR refers to the noncommercial, research version of QMR, the DDSS developed by Miller et al. [6]. The commercial version of QMR, previously marketed by First DataBank, while initially identical to R-QMR in 1990, was developed independently of R-QMR after that time. The commercial version of QMR is no longer marketed. Since 2014 Miller and colleagues at Vanderbilt have been developing a third-generation non-commercial successor system, “AskVanderbilt”.
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Miller, R.A. (2016). Diagnostic Decision Support Systems. In: Berner, E. (eds) Clinical Decision Support Systems. Health Informatics. Springer, Cham. https://doi.org/10.1007/978-3-319-31913-1_11
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