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A project to develop a clinical decision aid system is proposed, based on a multicentric design and on the application of epidemiological methods to the analysis of clinical data bases and clinical judgment. The knowledge of the prevalences of the most common diseases in the treated virtual population allows the assessment of diagnostic predictivities, and the provision of objective probabilities as a reference for the expert system. The characteristics of the system proposed are be described.

A model of structure for a complementary expert system to the AEDMI project (An Epidemiological Approach to Computerized Medical Diagnosis) is proposed. Starting from a diagnosis of abnormality in a system or apparatus, the model identifies the organ affected, and determines which of the possible illnesses is the one we are faced with in a particular case. The resoning is based on a tree-like structure divided into a set of three levels, assuming that greater sensitivity and less specificity of the questions, clinical variables, and the signs and symptoms to be taken into consideration is found at level I than at level III. Each time that the system is consulted for a real patient, the system offers the possibility to register all the parameters in a data base. The modules, rules, and diagnoses are registered and compared with physicians1 judgment. The study of conflicting patterns helps to analyze clinical judgment and rule-based reasoning techniques in greater depth. The system is being implemented for more than one year and the data from 825 patients introduced are being currently assessed.