Comparison between diagnoses of human experts and a neurotologic expert system.

The decision-making ability of a recently developed neurotologic expert system was compared with the diagnoses of six physicians. Five of the physicians were residents and one was a specialist in the field of otolaryngology. The test patients were randomly selected from vertiginous patients referred to an otolaryngology clinic. The expert system and the physicians first had identical information on patient history, symptoms, and tests. During the second phase of the study the physicians were allowed to use the full medical records. The correct diagnoses were certified by an experienced specialist in neurotology. The expert system did better in decision-making when both the expert system and the physicians had identical information on patients. However, when the physicians were allowed to use patient's complete medical records, they surpassed the expert system. The expert system diagnosed 65% of the cases, while the physicians first diagnosed 54% of the cases, and then with complete information, 69% of the cases. From the patients' medical records, the physicians obtained information on the time perspective of the symptoms and the progression of the disease. These aspects will be used to further improve the expert system.