TY - JOUR
T1 - Differential diagnosis of jaundice
T2 - junior staff experience with the Copenhagen pocket chart
AU - Malchow‐Møller, Axel
AU - Mindeholm, Linda
AU - Rasmussen, Henrik Sandvad
AU - Rasmussen, Bo
AU - Wilhelmsen, Flemming
AU - Petersen, Jørgen Schmidt
AU - Jørgensen, Susanne
AU - Hilden, Jørgen
AU - Thomsen, Carsten
AU - Matzen, Peter
AU - Juhl, Erik
PY - 1987/12
Y1 - 1987/12
N2 - ABSTRACT— Originally published in 1984, the Copenhagen Pocket Chart for early differentiation between causes of jaundice has been tested with success in centres outside Denmark. Using a logistic discrimination model, it estimates probabilities of obstruction and non‐obstruction in each case (and provides a further subdivision if desired). Here we evaluate its performance in the hands of young clinicians on a consecutive series of 173 jaundiced patients from two Danish hospitals. The chart performed as well as in the original series: confident diagnoses (probability ≥ 0.80) were assigned to 124 patients; of these 115 proved correct (93%). In 46 patients diagnostic probabilities were <0.80, and 3 patients had an unknown cause of jaundice. There were 108 cases in which physician and chart were in agreement, both with a confident diagnosis, and only one of these cases was wrong. In one hospital, contributing 107 cases, each patient was independently examined by a medical student in addition to the physician's examination. Student performance was equally good, practically speaking, in particular when taking the scores on the chart into consideration. As to observer disagreement, the student and the physician typically differed on 0–2 of the chart's 21 items. In no case, however, did this lead to a confident obstructive diagnosis being changed into a confident diagnosis of non‐obstruction, or vice versa.
AB - ABSTRACT— Originally published in 1984, the Copenhagen Pocket Chart for early differentiation between causes of jaundice has been tested with success in centres outside Denmark. Using a logistic discrimination model, it estimates probabilities of obstruction and non‐obstruction in each case (and provides a further subdivision if desired). Here we evaluate its performance in the hands of young clinicians on a consecutive series of 173 jaundiced patients from two Danish hospitals. The chart performed as well as in the original series: confident diagnoses (probability ≥ 0.80) were assigned to 124 patients; of these 115 proved correct (93%). In 46 patients diagnostic probabilities were <0.80, and 3 patients had an unknown cause of jaundice. There were 108 cases in which physician and chart were in agreement, both with a confident diagnosis, and only one of these cases was wrong. In one hospital, contributing 107 cases, each patient was independently examined by a medical student in addition to the physician's examination. Student performance was equally good, practically speaking, in particular when taking the scores on the chart into consideration. As to observer disagreement, the student and the physician typically differed on 0–2 of the chart's 21 items. In no case, however, did this lead to a confident obstructive diagnosis being changed into a confident diagnosis of non‐obstruction, or vice versa.
KW - algorithm
KW - computer‐aided diagnosis
KW - differential diagnosis
KW - jaundice
KW - observer variation
UR - http://www.scopus.com/inward/record.url?scp=0023578939&partnerID=8YFLogxK
U2 - 10.1111/j.1600-0676.1987.tb00364.x
DO - 10.1111/j.1600-0676.1987.tb00364.x
M3 - Article
C2 - 3437795
AN - SCOPUS:0023578939
SN - 0106-9543
VL - 7
SP - 333
EP - 338
JO - Liver
JF - Liver
IS - 6
ER -