XPHEMO: a rule-based expert system for laboratory diagnosis of hemoglobin disorders

• Abstract:
  This expert system illustrates the utility of a rule-based expert system to diagnose hemoglobin disorders. Laboratory data (i.e., results of hemoglobin electrophoresis, quantitative measurements of hemoglobin F and hemoglobin A2 levels, and result of a sickle cell screen) are processed by the system using defined rules to obtain a set of differential diagnoses. Additional data such as hematologic parameters, ethnicity of the patient, and the presence or absence of certain clinical signs and symptoms aid in making a final diagnosis. The rules in the current version of this expert system include 111 diagnostic criteria for 71 hemoglobin disorders. We tested the system by using 58 survey sample cases offered by the College of American Pathologists during the period of January 1989 through December 1994. The expert system included the actual diagnosis as one of the top four differential diagnoses in 90% of the cases, whereas all the laboratories participating in the survey included it in 84% (mean) of the cases. We propose that this user-friendly expert system is a potential tool for computer-assisted diagnosis of hemoglobin disorders.
  
  
• Development platforms:
  The inference engine of XPHEMO was implemented with the XP shell. The graphic user interface of XPHEMO was designed with Microsoft Visual Basic (Microsoft Corp., Redmond, Washington).
  
  Before beginning this project, we developed a version of our expert system shell, XP (for eXPert), for general applications. This shell was written in Microsoft Visual C++ language and was run on a Microsoft Windows 3.1 platform on an IBM-compatible computer. This shell has also been ported to other software platforms, including Borland C++ (Borland, Santa Cruz, California) and ANSI C, and other operating systems, including UNIX and Microsoft DOS. The XP shell is rule-based, and its inference engine uses a backward-chaining search strategy to draw conclusions.
  
  
• Publication:
  Nguyen, A.N.D., Hartwell, E., Milam, J.: A Rule-Based Expert System For Laboratory Diagnosis of Hemoglobin Disorders. Archives of Pathology & Laboratory Medicine. 1996; 120:817-827

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