To the Editor. —
The Journal has, during the past 2 years, brought to the attention of its readers information about two available computer-assisted diagnostic systems: DXplain, described in 1987,1 and our system, MEDITEL, reviewed this year.2The evaluation of such systems has posed new challenges for medical journals, as articulated by a pioneer in medical informatics, the late Dr Marsden Blois.3 The development of fair, objective, and appropriate methods requires consideration of the special characteristics of computer systems in contrast to books or scientific reports.Relative to the two systems, a recent publication compared the performance of DXplain and MEDITEL in 103 serial admissions to the inpatient internal medicine wards of a major university hospital not involved in the development of either system.4 Both ease of use (time for system access and data entry) and accuracy (inclusion of the correct diagnosis in the system output)
Waxman HS, Worley WE. MEDITEL. JAMA. 1989;262(23):3270–3271. doi:10.1001/jama.1989.03430230042017
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