Demonstration prototype of a decision support system designed to clinical interpretations of laboratory tests results from the first level indicative coagulogramma

Results of the first phase of the study in which the task was to create a demonstration prototype of a decision support system for the interpretation of first level indicative coagulogramm in children with hemorrhagic diathesis with specific type of bleeding (gematomny, microcirculatory or mixed ) are presented. The indicative coagulogram 1st phase includes the following laboratory parameters (activated partial thromboplastin time - PTT, prothrombin time - PT, thrombin time - TT, the concentration of fibrinogen, bleeding time - BT number of platelets in the blood). The study reveals abnormalities indicating pathology of individual links of the hemostatic system.

Of the 52 final diagnoses formed 10 'generalized' diagnostic conclusions, including from one to 12 final diagnoses that have the same combination of values of indicative coagulogram parameters: 1) Violations of the intrinsic pathway of blood coagulation, 2) Violations of the extrinsic pathway of blood coagulation, and 3) Violations of thrombin 4) gipofibrinogenemia 5) afibrinogenemia 6) dysfibrinogenemia 7) thrombocytopathy; 8) thrombocytopenia, 9) Von Willebrand Disease, 10) of factor XIII deficiency.

Comparison of laboratory pictures, identified in a patient, with laboratory portraits of 'generalized' diagnostic conclusions used as a diagnostic decision making algorithm

Trial operation of the system was carried out on 154 patients retrospective data, which showed that the correct "generalized" diagnostic conclusion goes to the 1st place in 96% (88% - 99%) of cases. Thus, the diagnostic hypothesis formed as a result of indicative coagulogram is reduced from 10 to 1 - 2 'generalized' diagnostic conclusions.