KANDID–an EMG decision support system–evaluated in a European multicenter trial |
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Authors: | Sren Vingtoft Anders Fuglsang-Frederiksen Jesper Rnager Jorge Petrera Bent Stigsby Robin G Willison John A Jarratt Peter R W Fawcett Ian S Schofield George Otte Guido Sieben Annick Vila |
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Institution: | Søren Vingtoft,Anders Fuglsang-Frederiksen,Jesper Rønager,Jorge Petrera,Bent Stigsby,Robin G. Willison,John A. Jarratt,Peter R. W. Fawcett,Ian S. Schofield,George Otte,Guido Sieben,Annick Vila |
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Abstract: | KANDID is an advanced EMG decision support system dedicated to the support of the clinical neurophysiologist during EMG examinations. It has facilities for test planning, automatized and structured data interpretation, EMG diagnosis, explanation, and reporting. In a prospective European multicenter field trial, the agreement levels between clinical neurophysiologists and KANDID's diagnostic statements were measured under ordinary clinical EMG practice. KANDID was assessed in 159 individual patient EMG examinations by nine clinical neurophysiologists at seven different EMG laboratories. The reasoning of KANDID was considered understandable for the examiners in 80–90% of cases. The agreement level for the electrophysiological states of muscles and nerves between KANDID and the individual examiners was, on average, 81%. The corresponding diagnostic agreement with KANDID was, on average, 61%. A pronounced interexaminer variation in the agreement level related to the different EMG centers was observed. All Danish and Belgian examiners agreed with KANDID in more than 50% of their cases with regard to the EMG diagnosis, while the English examiners were in agreement with KANDID in 50% or less of their cases. These differences were possibly due to differences in epidemiology, examination techniques, control material, and examination planning strategies. It is concluded that it is possible to transfer systems like KANDID out of their development sites and apply them successfully if they can be locally customized by the clinical end users via editors. © 1993 John Wiley & Soncs, Inc. |
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Keywords: | EMG expert system decision support neuromuscular disorders multicenter evaluation transferability |
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