ABSTRACT
A two-part study was designed to test the hypothesis that sufficient information is available from a modern hematology analyzer (the Coulter STKS) to reach a reliable intermediate conclusion which can be used as input to the next decision-making level in the design of a high-performance expert system for hematology diagnosis. In phase one, we analyzed the performance of three probabilistic systems (using Bayes' rule) which interpret STKS data: a control system which took the traditional approach of classifying cases into specific diagnoses, and two test systems which were designed to reach only an intermediate conclusion but not a final diagnosis. One of the test systems classified cases into "textbook categories" of disease and the other utilized defined diagnostic patterns. The systems were tested with 150 cases. The pattern approach ranked the correct choice first in 141 of 150 cases (94%). In phase two, we abandoned Bayes' rule, reformulated the pattern approach into a heuristic classification system, and tested its reliability on 820 cases. The algorithm of the reformulated system was able to classify all 820 cases into the same predominant pattern as a panel of three experienced laboratory hematologists.
Subject(s)
Diagnosis, Computer-Assisted , Expert Systems , Hematologic Diseases/diagnosis , Algorithms , Bayes Theorem , HumansABSTRACT
An expert system is described that includes interpretation of the results from a complete blood count as well as data from bone marrow aspiration. The system utilizes Bayes' rule. It has previously been tested on 180 cases of anemia including 20 benign and malignant hematologic disorders. On the data set, the system achieved 84% satisfactory diagnoses. In the present study, patients with myelodysplastic syndromes and with disorders of heme synthesis have been added to the test cases. For support, the expert system requires an IBM Personal Computer or equivalent. The program is available commercially (Coulter Electronics, Hialeah, FL).
Subject(s)
Anemia/diagnosis , Expert Systems , Myelodysplastic Syndromes/diagnosis , Humans , SoftwareABSTRACT
We have developed a new decision-making system which includes interpretation of complete blood count (CBC). The system works using Bayes' rule. We tested the CBC program for the diagnosis of 180 cases of anemia covering 20 benign and malignant hematological disorders. The data entered were obtained from a Coulter S + IV/HD and the interpretation of blood smears. Clinical information was not used. In 64.5% of cases, the correct diagnosis was displayed in first rank and in 20%, in second or third rank, giving a total of 84% of quite satisfactory responses. There were only 5% incorrect responses, but the proposed complementary tests rectified the error. Computer-aided diagnosis can help pathologists, clinicians, students, and technicians to make rapid correct diagnoses and choose the appropriate tests to perform. These programs run on IBM PC or similar microcomputers and are available from Coulter Electronics, Hialeah, FL.
Subject(s)
Anemia/diagnosis , Decision Making, Computer-Assisted , Expert Systems , Hematologic Diseases/diagnosis , Anemia/etiology , Blood Cell Count , Hematologic Diseases/complications , HumansABSTRACT
An aid to decision programme has been applied to 200 cases of anaemia. Evaluation by the bayesian method rested on clinical data (age, sex, race) and laboratory data (blood count and differential, erythrocyte morphology). An accurate diagnosis was made initially in 107 cases, and for the first 5 diseases in 173 cases. The programme proved more effective than two clinicians recently trained in haematology. Devised for micro-computers, it can be used in routine practice and for teaching purposes.
Subject(s)
Diagnosis, Computer-Assisted , Hematologic Diseases/diagnosis , Software , Anemia/diagnosis , Humans , MicrocomputersABSTRACT
Serum ferritin has been assayed by two methods. Radio-Immunology and Enzymo-Immunology in two group of young females. Iron deficiency is considered as unequivocal if serum ferritin is lower than 20 micrograms/l whatever the method used analysis of red cell indices in iron deficient females has shown that anemia, hypochromia and microcytosis are very late events and that their sensitivity for the diagnosis if iron deficiency is very poor.
Subject(s)
Anemia, Hypochromic/diagnosis , Anemia, Hypochromic/blood , Erythrocyte Indices , Evaluation Studies as Topic , Female , Ferritins/blood , Humans , Immunoenzyme Techniques , Radioimmunoassay , Reagent Kits, DiagnosticABSTRACT
A computer program to identify normal and pathological blood and marrow cells is presented. It requires an analysis of cellular morphology according to ten simple criteria. These criteria are treated by the Bayesian method; then the program offers, in decreasing order, the cells which are best classified. The responses are analyzed and discussed. This program seems to be well suitable to a computer-assisted teaching (CAT) of cytology. It supplements effectively the traditional methods.
Subject(s)
Blood Cells/cytology , Bone Marrow Cells , Software , Bayes Theorem , Blood Cells/pathology , Bone Marrow/pathology , Diagnosis, Computer-Assisted , Humans , Lymphocytes/pathology , Lymphoproliferative Disorders/blood , Lymphoproliferative Disorders/pathology , MicrocomputersABSTRACT
Monoclonal origin of human lymphocyte colonies grown in agar culture under mitogenic stimulation is still disputed. To solve this question we used different markers: we failed with the G6PD technic and with the successive staining for X and Y chromosomes on individual colonies. Therefore, individual colonies were investigated for the presence of different cell types using membrane receptor identification and cytochemistry. At different stages of the colony formation, presence of a macrophage surrounded by lymphocytes, of a mixture of T cells and B cells, plasma cells and c.Ig negative cells, in the same colony was demonstrated. The mixture of cells from different lineages in individual colonies indicated a polyclonal origin of such colonies, the capacity for the cells to migrate in a short distance, and the involvement of cell-cell contact throughout the colony formation. Human lymphocyte colony formation appears as a new technic for the study of cellular cooperation.
