Nature and Purpose of the Medical Data Screen

A physician may require information about a patient's symptoms beyond those associated with the present illness. The Medical Data Screen (MDS) meets this need by rapidly making available to the physician a large body of comprehensive information concerning a patient's medical and psychiatric symptoms to assist him in the diagnosis of any of 100 common diseases.

In the operation of the MDS, a patient reports his symptoms by answering questions on the Medical Data Index-Health Questionnaire (MDI). An electronic computer, programmed with the MDS, next matches the patient's symptoms with complexes of symptoms often found in these 100 diseases, and the names of the diseases for which the patient is found to have significant complexes of symptoms are then reported to the physician.

This computer-aided method of medical data screening is essentially a laboratory procedure. It makes use of modern technology to supply the physician with a large body of information about a patient's symptoms otherwise not readily obtainable. The physician uses information obtained with the Medical Data Screen in a manner similar to his use of any laboratory finding, i.e., in conjunction with all information collected concerning the patient and in accordance with his own clinical judgment and experience.

The MDS method attempts a difficult task—namely, to assign unselected patients to any one or more of 100 diverse disease categories, using as the basis for assignment only the answers to a self-administered questionnaire. It performs this task with a large proportion of correct assignments and a low incidence of false positive assignments. It should not be confused in its purpose and effectiveness with other computer methods which attempt to identify one of a few related

analysis, the patient's symptoms are matched with the symptoms of other patients who were diagnosed by physicians as having any of the 100 diseases.

4. Results of the computer analysis are sent to the physician for his interpretation and use in the form of a report listing those diseases for which the patient has claimed significant complexes of symptoms.

Technique of Using the MDS Method

The MDS is designed to supply information to the physician to assist him during his investigation of the total medical problem of patients, teen-aged through elderly. It may be used by the physician at the time of comprehensive examination of the patient, or preliminary to such examination when temporary deferral of the examination is indicated because of the pressing nature of the patient's immediate medical problems.

It has been found that the most effective technique for using the MDS as part of the physician's examination of the patient is for the MDI questionnaire to have been completed and the results of the MDS analysis known to the physician prior to the time of examination. This procedure permits the physician to draw provisional diagnostic inferences which he can test at the time of examination.

Until all examinations are completed, the MDS report remains a record of disease complexes. After the patient has been examined fully, and when tests and consultations are completed, the physician may make any necessary additions or modifications to the MDS report. The report can then serve as a systematized and detailed diagnostic record of the physician's medical appraisal of the patient at the time of examination and as a summary for future reference and comparison.

The MDS Report to the Physician

Results of the MDS analysis are reported to the physician on the MDS output sheet in the form of

a letter addressed to the physician, which identifies the diseases for which the patient made significant complexes of complaints on the MDI questionnaire. It designates the patient's name, address, sex, age, and the dates on which the questionnaire was completed and received for analysis.

Each disease named in the report is associated with the name of the organ system in which it occurs. Detailed information for each disease includes the International Classification of Diseases numerical code designation for the disease identified, the name of this disease as it appears in the ICD, and the MDS alphabetical code designation and name for each associated organ system. The use of the MDS output sheet is facilitated by data being printed in standard medical nomenclature and by the arrangement of these data by organ systems.

Interpretation of the MDS Report

General

As has been stated, the computer lists on the MDS report the names of the diseases for which a patient claimed significant complexes of symptoms. When interpreting this information, the physician will recognize that these symptoms were claimed for any one of four reasons:

1. The patient has the disease named.

2. The patient has a closely related disease which produced a constellation of symptoms resembling that usually found in the disease named.

3. The patient has an emotional disturbance with complaints similar to those usually found in the disease named.

4. The reason may be obscure, as is occasionally the case. It may be, for example, as happens in atypical cases, that the reference data do not apply to a particular patient.

In all instances, the physician decides which of the reasons applies by interpreting the MDS report in the context of all of the data concerning the patient which he has available to him both from the report and all