On the applicability of diagnostic criteria for the diagnosis of rheumatoid arthritis in an expert system

摘要

Cadiag-2/Rheuma is a medical expert system developed to assist in the differential diagnosis of rheumatic diseases. Based on fuzzy set theory and fuzzy logic, it supports the formalization of vague and uncertain medical information (i.e., medical entities and relationships between them) and draws justifiable conclusions from these imprecise data. Given a patient's finding patter, Cadiag-2 provides confirmed and excluded diagnoses, diagnostic hypotheses, and suggestions for further examinations. The knowledge base of Cadiag-2 has been designed to contain simple finding/disease relationships as well as diagnostic rules of high complexity to confirm or hypothesize disease. We shall present results obtained with 300 clinical cases from a hospital for rheumatic diseases. Different rules for the diagnosis of rheumatoid arthritis based upon classification criteria issued by the American Rheumatism Association were tested against each other. That diagnostic rule which had shown the best results was then further improved by a rheumatology expert, which finally yielded a sensitivity of 83.3% and a specificity of 95.3%.