G lobal I nfectious D isease and E pidemiology O nline N etwork GIDEON By Abel Medhanie Gebreyesus Sunil Nair HINF6230 – Technology Assessment

Important Facts 345 Diseases 231 Countries 339 Drugs & Vaccines 1409 Microbes 35,800 References 16,228 Country Specific Notes 6,835 Disease outbreaks 4,205 Images and Maps Source:www.ebscohost.com

345 Diseases

231 Countries

339 Drugs & Vaccines

1409 Microbes

35,800 References

16,228 Country Specific Notes

6,835 Disease outbreaks

4,205 Images and Maps

Source:www.ebscohost.com

GIDEON Web-based Infectious Disease Diagnosis computer program that constructs a differential diagnosis [DD], ranked in order of percent probability based on specific clinical data entered by user. Updated weekly CD-ROM updated every month Developed in 1994, Proprietary – Subscription. Used in 1500 Institutions worldwide

Web-based Infectious Disease Diagnosis computer program that constructs a differential diagnosis [DD], ranked in order of percent probability based on specific clinical data entered by user.

Updated weekly

CD-ROM updated every month

Developed in 1994, Proprietary – Subscription.

Used in 1500 Institutions worldwide

GIDEON Users Emergency room Physicians Infectious Disease Specialist Public Health Officials Pediatricians Medical Schools Other Health care workers

Emergency room Physicians

Infectious Disease Specialist

Public Health Officials

Pediatricians

Medical Schools

Other Health care workers

Highlights Point-of-care Current or up-to-date Diagnosis, Treatment, teaching resource Global

Point-of-care

Current or up-to-date

Diagnosis, Treatment, teaching resource

Global

GIDEON Modules Diagnosis out put differential diagnosis “ why not” Epidemiology Transmission, diagnosis and treatment Country specific. Therapy Drugs, vaccines, interactions, adverse effects Microbiology Identify the Pathogen

Diagnosis

out put differential diagnosis

“ why not”

Epidemiology

Transmission, diagnosis and treatment

Country specific.

Therapy

Drugs, vaccines, interactions, adverse effects

Microbiology

Identify the Pathogen

DIAGNOSIS

EPIDEMIOLOGY

THERAPY

MICROBIOLOGY

DEMO DIAGNOSTIC MODULE EPIDEMIOLOGY MODULE

DIAGNOSTIC MODULE

EPIDEMIOLOGY MODULE

HOW GIDEON WORKS PROBABILISTIC SYSTEM BAYESIAN THEOREM MySQL DATABASES WEB-INTERFACE USING PHP

PROBABILISTIC SYSTEM

BAYESIAN THEOREM

MySQL DATABASES

WEB-INTERFACE USING PHP

GIDEON Model MEDICAL EXPERT KNOWLEDGE DATA BASE BAYESIAN NETWORK INFERENCE ENGINE USER INTERFACE END USER

Bayesian Theorem Application in clinical decision making estimate the probability of a particular diagnosis given specific signs, symptoms, or test outcomes. Sensitivity and Specificity Conditional Probability: given that test is +ve [-ve] then diagnosis is true [false] Complexity of the Statistical inference depends on Specificity of the patient findings.

Application in clinical decision making

estimate the probability of a particular diagnosis given specific signs, symptoms, or test outcomes.

Sensitivity and Specificity

Conditional Probability: given that test is +ve [-ve] then diagnosis is true [false]

Complexity of the Statistical inference depends on Specificity of the patient findings.

Comparison n=86, Accuracy of clinical diagnosis 33% compared to Medical officers with 87% correct diagnosis. DD, Updated weekly. info on epidemiology, therapy and Microbiology GIDEON n=103, Accurately diagnosed 73% cases. Provides DD based on clinician entered Signs & Symptoms. Updated weekly. Dxplain n=295, Accurately diagnosed 75% cases. Clinical diagnosis listed in 94.7% cases. Provide DD, general info on pathogens and vaccines of Infectious Diseases Computer Program for Diagnosing and Teaching Geographic Medicine Evaluation* Purpose System Name

LIMITATIONS Accuracy Correct diagnosis listed down in order Study – correct diagnosis listed 69%; ranked first 60% of the time. Depends on Quality of input data Presence of irrelevant data Complex [co-morbid] cases Reliance on literature for data Delay in database update Not User Specific and area specific

Accuracy

Correct diagnosis listed down in order

Study – correct diagnosis listed 69%; ranked first 60% of the time.

Depends on Quality of input data

Presence of irrelevant data

Complex [co-morbid] cases

Reliance on literature for data

Delay in database update

Not User Specific and area specific

Conclusion GIDEON is an impressive tool in infectious disease diagnosis that uses the power of the internet to provide access to and presentation of data to the infectious disease community. There is need for further evaluation with regards to accuracy Probably have separate versions focusing the specific user groups.

GIDEON is an impressive tool in infectious disease diagnosis that uses the power of the internet to provide access to and presentation of data to the infectious disease community.

There is need for further evaluation with regards to accuracy

Probably have separate versions focusing the specific user groups.

References Stephen A Berger GIDEON: a comprehensive Web-based resource for geographic medicine Published: 22 April 2005 International Journal of Health Geographics 2005, 4 :10 Stephen C. Edberg , Global Infectious Diseases and Epidemiology Network (GIDEON): A World Wide Web–Based Program for Diagnosis and Informatics in Infectious Diseases, Clinical Infectious Diseases 2005;40:123–126 Dena M. Bravata et al., Evaluating Detection and Diagnostic Decision Support Systems for Bioterrorism Response. Emerging Infectious Diseases • www.cdc.gov/eid • Vol. 10, No. 1, January 2004 Global Infectious Diseases and Epidemiology Network (GIDEON) Julia Kulla-Mader INLS 279: Bioinformatics Research Review 2006-04-12 Use of the Computer Program GIDEON at an Inpatient Infectious Diseases Consultation Service Robert F. Luo and John G. Bartlett Clinical Infectious Diseases 2006; 42:157–7 _ 2005

Stephen A Berger GIDEON: a comprehensive Web-based resource for geographic medicine Published: 22 April 2005 International Journal of Health Geographics 2005, 4 :10

Stephen C. Edberg , Global Infectious Diseases and Epidemiology Network (GIDEON): A World Wide Web–Based Program for Diagnosis and Informatics in Infectious Diseases, Clinical Infectious Diseases 2005;40:123–126

Dena M. Bravata et al., Evaluating Detection and Diagnostic Decision Support Systems for Bioterrorism Response. Emerging Infectious Diseases • www.cdc.gov/eid • Vol. 10, No. 1, January 2004

Global Infectious Diseases and Epidemiology Network (GIDEON) Julia Kulla-Mader INLS 279: Bioinformatics Research Review 2006-04-12

Use of the Computer Program GIDEON at an Inpatient Infectious Diseases Consultation Service Robert F. Luo and John G. Bartlett Clinical Infectious Diseases 2006; 42:157–7 _ 2005