A model-based system to determine the relative value of different variables in a diagnostic system using Bayes theorem.

A model system is described which simulates the presenting features of cases of vaginal discharge. This system was used to examine the effects of removing individual clinical features on the overall efficiency of diagnosis by Bayes theorem. The diagnostic efficiency was significantly reduced by elimination of inflammation, of a frothy discharge, or of a curdy discharge. Elimination of more than one significant factor further reduced the number of correct diagnoses, but elimination of more than one non-significant factor made no obvious difference. The most significant clinical feature was presence of inflammation; elimination of this feature had a substantial effect on the diagnosis of gardnerella, viral, gonorrhoea and foreign body. Elimination of two of the variables (bloodstaining and odour) which did not influence overall diagnostic efficiency nevertheless had a substantial effect on the diagnosis of neoplasms and foreign bodies. It is proposed that a simulation of this type is of potential practical value in determining a minimum subset of clinical features for diagnostic systems involving Bayes theorem.

Solution to the disability income problem.

The probability of a serious disability before age 65 is much greater than the probability of death, yet most dentists have done a better job of protecting themselves against the event less likely to occur. This article explores how much and what kind of disability insurance a dentist should own and discusses in depth the contractual provisions of quality disability income policies.

Follow-up of adolescent trauma victims: a new model of care.

A comprehensive model of service delivery for the rehabilitative care of adolescents with closed head injuries is presented. Our data show that the Glasgow Coma Scale score on hospital admission correlates with the length of time required for follow-up. Adolescents with mild closed head injuries require more follow-up than adults with comparable injuries because of adolescent developmental stages that complicate the recovery process. Anticipatory guidance has helped the patient and family cope with stresses. Finally, we have identified a typical pattern of difficulties during the recovery process including: impaired judgment, reduced attention span, irritability, short-term memory loss, and ongoing memory deficits.