Epilepsy histories obtained by the computer interview were similar in substance and detail to histories recorded by house staff and attending physicians. In general, more information was obtained by the computer, and negative findings were consistently recorded by the computer. For potentially embarrassing questions, the computer may obtain more accurate information (Slack and Van Cura, 1968b). This might explain the contradictions concerning incontinence and medication. This preliminary study suggests that computer interviewing can provide a reliable method for obtaining epilepsy histories. The study also pointed out where changes in question wording and branching logic would improve the computer interview. These changes are being incorporated into the second version of the epilepsy interview. We hope computer-based interviewing will prove useful to patients and physicians in the diagnosis, treatment, and study of epilepsy.
A computer program has been developed to assist the physician in managing patients with hypercalcemia. The program requests appropriate information, such as the patient's serum calcium concentration, age and x-ray results. Based on the abnormalities detected, the program asks additional questions needed to suggest the most helpful course of action for evaluating or treating the patient's hypercalcemia. As soon as the data have been entered, the program generates an evaluation note that includes diagnostic possibilities, suggestions for additional laboratory studies, therapeutic recommendations and references to the medical literature. The program can be used from any general purpose teletype-compatible terminal (including cathode ray tube displays) connected to the Bell Telephone System. The time required to enter the data and obtain the evaluation note is approximately 4 minutes with a teletypewriter, and less if a faster terminal is used. The cost for computer time is comparable to that of a laboratory test. Comparison of diagnoses produced by the program with those obtained from pathologic examination of from consulting endocrinolgists shows that the program is sufficiently accurate for clinical use. Finnally, the explanation of the pathophysiology contained in the evaluation note may be useful to the student.
With the advent of electronic computers that operate in the time-sharing mode, it has become possible to develop an automated system that can assist a physician in solving clinical problems. In the present study a teletype terminal has been linked to a time-sharing computer which has been programmed to evaluate clinical and laboratory information concerning patients with acid-base disorders. The program checks the data for evidence of internal consistency and requests additional information as needed to solve the acid-base aspects of the clinical problem. If sufficient information is provided, the program generates an evaluation note designed to review with the physician the pathophysiology of the disorder and to assist him in its management. If the input data are incomplete, the program draws the most useful conclusions possible based on the data provided, specifies the limitations which pertain to these conclusions, suggests further studies designed to circumvent these limitations, and while awaiting the results, suggests appropriate interim therapeutic measures. The time required to enter a patient's data and to print the evaluation note is approximately 4 min; the cost is comparable to that of many laboratory tests.