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U. Wiehler, R. Schmidt, S. Skonetzki, M.D. Becker; Computer Based System for Optimised Strategies for Differential Diagnosis of Secondary Forms of Uveitis . Invest. Ophthalmol. Vis. Sci. 2005;46(13):5105.
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© ARVO (1962-2015); The Authors (2016-present)
Purpose: A long list of ophthalmologic findings and symptoms at the baseline exam of a patient with uveitis can have impact on further laboratory workup and differential diagnosis. The used algorithms are often confusing for the inexperienced. An online–questionnaire for recommendations for the diagnostic strategy of further investigations as well as for training purposes concerning characteristic features of secondary forms of uveitis has been demanded repeatedly. Methods: Based on publications and previous work a decision tree was transformed into the expert system shell D3. Criteria and parameters for the recommendation of further laboratory work–up were implemented from the literature. Terminology was clearly defined and illustrated by pictures and examples. Based on these prototypes a web–based Java Servlet was programmed and published on our website (www.uveitiscenter.de at DiagnoseFinder). Ophthalmologic findings and symptoms of the patient are checked with this online–questionnaire. This servlet works on Apache Tomcat Web–Servers and guides the user through different individually generated web sites. Finally, recommendations for further laboratory tests and further care of the patient are given. The program was tested retrospectively with 50 patients of our Uveitis center. Results: First experiences show a high accuracy of the program in the classification of differential diagnoses and in the recommended strategy concerning laboratory investigations. Conclusions: This program is meant to be an easily accessible and simply employable help for the care of patients with a secondary form of uveitis. It was intended to be a support for residents in particular but also for ophthalmologists in private practice that rarely treat patients with uveitis. Further validation of the given recommendations will be achieved by testing the program in different uveitis centers to ensure a better applicability and quality of the program.
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