Indian Journal of Medical Informatics May 2004 Vol.1; No.1 ISSN: 0973-0397 25 Automated Diagnostic Systems Suptendra Nath Sarbadhikari School of Medical Science and Technology Indian Institute of Technology, Kharagpur 721 302 Presently at: Amrita Vishwa Vidyapeetham Email: supten@amrita.edu , drsupten@yahoo.com Abstract: Reaching a foolproof diagnosis is never an easy job for a clinician. Often, a simple diagnostic procedure or test is overlooked and the disease eludes diagnosis. Clinical reasoning and decision making are phased. Initially there is a clinical evaluation (history taking and physical examination), followed by precise laboratory investigations. Then integration of clinical findings and test results is done. After that, comparative benefits and risks are weighed among the alternative courses of actions, like drug interactions. Finally, the patient's preferences are taken into account, along with ethical and other considerations like cost of therapy, compliance expectations and a therapeutic plan is developed. Right from the first step (history taking) to the final one, computers can be of immense help to the clinician. CDSS (Clinical or Diagnostic Decision Support Systems) are Interactive computer programs, which directly assist physicians and other health professionals with decision making tasks. I have the pleasure of developing some diagnostic decision support systems for medical education and research. Intuitive thought processes involve rapid unconscious data processing and combines available information by law of average and therefore, has a low intra- and inter-person consistency. So, the clinician of today should move towards analytic decision making, which albeit typically slow, is conscious, consistent and clearly spells out the basis of decision. Nevertheless, for computer-assisted diagnostic systems, a human clinician ("man in the loop" for "Intelligence Amplification") must be a necessary component. Moreover, the clinician must understand completely the strengths and limitations of them. Computerized diagnostics and clinical acumen are not mutually exclusive; rather they should reinforce each other for the alleviation of psychosomatic or rather 'psycho-bio- social' suffering of mankind. However, with sophisticated gadgetry taking the upper hand, the "human touch" should not be overlooked or forgotten. Keywords: automated clinical diagnosis, analytic decision making, CDSS 1. Introduction Medical Informatics[1-7] is nothing but the science and art of processing (bio)medical information (where information is the processed data). The use of computers is inevitable here. The information may be retrieved both on-line (e.g., through Internet) or off-line (e.g., through CD- ROMS, floppies, magnetic tapes, and last but not the least: paper i.e., books and journals). EBM (Evidence Based Medicine) is gradually becoming popular for managing both common and uncommon medical problems. In this age of "Information Explosion" choosing the useful one is rather difficult, and that brings in the scope of data management and research. The usefulness of a database can be assessed only by its proper management (building, indexing and updating). However, still many outstanding personnel related to the healthcare sector take pride in being "computer illiterate". The gamut encompassing Bioinformatics is a rather wide one. While referring to Bioinformatics, one thinks of only genomics, proteomics, and drug design, but the importance of clinical informatics is no less. Another term Tele-health encompasses both e-health (electronic or Internet based services related to healthcare delivery) and telemedicine (healthcare services to remote locations). Reaching a foolproof diagnosis is never an easy job for a clinician. Often, a simple diagnostic procedure or test is overlooked and the disease eludes diagnosis. Clinical reasoning and decision making are phased. Initially there is a clinical evaluation, followed by precise laboratory