Pediatric Informatics: Computer Applications in Child Health (Health ...

170 M.J. Feldman
Fig. 12.4 GIDEON Diagnosis module: U.S. child with diarrhea and abdominal pain
Therapy module:
Contains information on 269 drugs and 65 vaccines. Therapeutic
information includes: mechanism of action, adult, and pediatric dosage, half life
and excretion, side effects, interactions, trade names, microbial spectrum and
susceptibility guidelines. A user can filter therapies by pathogen susceptibility,
side effects/toxicities and drug interactions.
Microbiology module:
This is an interface for accessing specifics on microbiology
laboratory data. A user can enter laboratory test-specific information about
organisms (e.g. catalase positive or negative, glucose fermenter or not) using the
same type of interface as the Diagnosis Module. The system returns a Bayesian
ranked list of any of the 1,147 possible organisms within the KB that fit the
29, 30
entered criteria.
Evaluation studies on GIDEON have been published, although they are not in
the pediatric age range. In one blinded study of 495 cases, the correct diagnosis
appeared in GIDEON’s differential list 94.7% of the time, and was ranked first in
75%. 31 In a study of 86 febrile inpatients over 18 years of age, GIDEON listed the
correct discharge diagnosis in the top five on 36% of cases; this rose to 69% when
irrelevant clinical findings were not entered. In the same study, junior residents
listed the correct diagnosis in 87% of cases. 32 In a study of 50 inpatient consultations
where all clinical data, regardless of perceived clinical relevance, were
entered, the infectious disease consulting team’s diagnosis was among GIDEON’s
top five diagnoses 22% of the time. In this study, the consulting team’s top diagnosis
matched the patient’s discharge diagnosis in 92% of cases. The authors note