Computer has answers to stomach aches

Press, 24 July 1986, Page 18

Computer has answers to stomach aches

By

ROBIN CHARTERIS

in London

Got a stomach ache? Don’t just tell the doctor — talk to his computer. According to a Govern-ment-funded research project in Britain, computers are far better than most doctors at diagnosing severe abdominal pains. The country’s Department of Health and Social Security discovered that some £23 million (S6SM) could be saved and thousands of patients could avoid unnecessary surgery and investigations if computers were used throughout Britain’s National Health service. If the scheme, for which the software already exists, were extended to cover other medical conditions, the savings could be 10 times as great, the survey revealed.

The project, organised by Leeds University, involved 250 doctors and 17,000 patients. Junior doctors who used the computer were as suc-

cessful in diagnosing patients as a consultant in a teaching hospital or a senior resident at Yale.

The proportion of patients reporting to hospital casualty departments with acute abdominal pains dropped from 41 per cent to 26 per cent, the survey found. The proportion of unnecessary investigations was almost halved. Appendicitis patients went to surgery earlier and the perforation rate was halved.

The number of bad clinical decisions fell by 80 per cent to 0.2 per cent Thirty-three fewer patients died during the trial period than would normally have been expected. The conditions diagnosed by computer included appendicitis, inflamed gall bladder, bowel obstruction, gynaecological problems, renal colic, pancreatitis and perforated ulcers. Mr Tim De Dombal, consultant surgeon at St

James’ Hospital, Leeds, who co-ordinated this project, said, “We have shown beyond any reasonable doubt how savings can be made and how doctors can perform better.”

He emphasised that doctors could not lose their skills or become over-reliant on computers. The programmes were actually a teaching aid — even after doctors stopped using the computer, their decision-making abilities improved, he said. “In fact, the computer forces the doctor to ask all the right questions before it can offer diagnosis. Computers are no substitute for the consultant, but they have a valuable role augmenting the skills of junior doctors who are often the first to see the patient.” Britain’s Department of Health, Regional Health Authorities and the Royal College of Surgeons are still considering the report, which was completed last November.