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  • 1.
    Martin, Lene
    Stockholm University, Sweden.
    Computer-assisted management of primary open-angle glaucoma. Knowledge acquisition and prototype testing1996In: Computers in Nursing, ISSN 0736-8593, Vol. 14, no 5, p. 267-271Article in journal (Refereed)
    Abstract [en]

    Primary open-angle glaucoma is a common disease afflicting 1% to 2% of people older than 50 years of age. The care of patients with glaucoma is a subject of debate because the disease is incompletely understood. The diagnosis relies on a number of examinations, many of them performed by ophthalmic nurses, and the care of patients with glaucoma has become one of the main tasks for ophthalmic nurses in Sweden. This study describes a knowledge-based system for decision support in glaucoma management, which uses seven data elements about the patient to arrive at one of 25 different recommendations for appropriate action. In 267 patient visits to five different eye clinics, the program recommendations were compared with the actual decisions made by the responsible physician. The concordance was 92% to 100% when policy differences among the clinics were taken into account. The program appears to provide substantial decision support in the management of primary open-angle glaucoma. The program's ability to support the ophthalmic nurses in the care of patients with open-angle glaucoma is being evaluated.

  • 2.
    Martin, Lene
    Karolinska Institutet, Sweden.
    Knowledge acquisition and evaluation of an expert system for managing disorders of the outer eye2001In: Computers in Nursing, ISSN 0736-8593, Vol. 19, no 3, p. 114-117Article in journal (Refereed)
    Abstract [en]

    The aim of the current study was to develop and evaluate an expert system for diagnosing outer eye disorders, intended to support family physicians and nurse practitioners in the management of patients with minor eye complaints. The knowledge in the program was gathered from the scientific literature and from 6 experienced ophthalmologists and 6 ophthalmic nurses. Fourteen diagnoses must be considered, and the differential diagnosis is dependent upon 32 signs and symptoms. The program calculates the most likely diagnosis, presents photographs of the typical ocular findings, and provides information regarding management and treatment. The program's output was compared with the diagnosis made by 8 other ophthalmologists at a Swedish university clinic, based on data from 157 patients with disorders of the outer eye, who visited the emergency ward during a one-week period. The concordance between the diagnosis made by the ophthalmologists and the program was 96%. In conclusion, the expert system for disorders of the outer eye provided essentially the same diagnostic information as an examination by an ophthalmologist. Support from the program would make it possible for family physicians and nurse practitioners to manage most of these patients.

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