An Online Evidence-Based Decision Support System for Distinguishing Benign from Malignant Vertebral Compression Fractures by Magnetic Resonance Imaging Feature Analysis.

Decision support systems have been used to promote the practice of evidence-based medicine. Computer-assisted diagnosis can serve as one element of evidence-based radiology. One area where such tools may provide benefit is analysis of vertebral compression fractures (VCFs), which can be a challenge...

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Publicado en:Journal of Digital Imaging Vol. 24; no. 3; pp. 507 - 516
Autores principales: Wang, Kenneth, Jeanmenne, Anthony, Weber, Griffin, Thawait, Shrey, Carrino, John
Formato: diagnostic images pictorial tables/charts Journal Article
Publicado: Springer Nature Jun2011
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Jun2011
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      pub: Springer Nature
      place: New York, New York
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        atl: An Online Evidence-Based Decision Support System for Distinguishing Benign from Malignant Vertebral Compression Fractures by Magnetic Resonance Imaging Feature Analysis.
      aug:
        au:
          Wang, Kenneth
          Jeanmenne, Anthony
          Weber, Griffin
          Thawait, Shrey
          Carrino, John
        affil: Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins Hospital, 601 North Caroline Street, Room 5165 Baltimore 21287 USA
      sug:
        subj:
          Decision Support Systems, Clinical
          Decision Making, Computer Assisted
          Fractures, Vertebral Compression Diagnosis
          World Wide Web Applications
          Fractures, Vertebral Compression Etiology
      ab: Decision support systems have been used to promote the practice of evidence-based medicine. Computer-assisted diagnosis can serve as one element of evidence-based radiology. One area where such tools may provide benefit is analysis of vertebral compression fractures (VCFs), which can be a challenge in MRI interpretation. VCFs may be benign or malignant in etiology, and several MRI features may help to make this important distinction. We describe a web-based decision support system for discriminating benign from malignant VCFs as a prototype for a more general diagnostic decision support framework for radiologists. The system has three components: a feature checklist with an image gallery derived from proven reference cases, a prediction model, and a reporting mechanism. The website allows users to input the findings for a case to be interpreted using a structured feature checklist. The image gallery complements the checklist, for clarity and training purposes. The input from the checklist is then used to calculate the likelihood of malignancy by a logistic regression prediction model. Standardized report text is generated that summarizes pertinent positive and negative findings. This computer-assisted diagnosis system demonstrates the integration of three areas where diagnostic decision support can aid radiologists: first, in image interpretation, through feature checklists and illustrative image galleries; second, in feature-based prediction modeling; and third, in structured reporting. We present a diagnostic decision support tool that provides radiologists with evidence-based guidance for discriminating benign from malignant VCF. This model may be useful in other difficult-diagnosis situations and requires further clinical testing.
      pubtype: Academic Journal
      doctype:
        diagnostic images
        pictorial
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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