DXplain - A Niche Resource for Just-In-Time Knowledge Access

A major interest in Medical Informatics is identifying information needs of clinicians and developing resources to attempt to meet these. The Internet has been of great importance in making knowledge resources immediately available at the point of care. Widespread use of the Internet has encouraged and facilitated the development and distribution of knowledge resources from governmental, commercial, and academic sites. DXplain is one such Internet resource and can be classified as a “niche” resource in that it focuses on the consideration and explanation of the relationship between many clinical manifestations and a plausible differential disease classification. When a clinician encounters a diagnostic dilemma, DXplain is one of the few knowledge resources available in this domain. The program explains and justifies its interpretations and provides access to a knowledge base concerning both the manifestations and the relevant diseases. DXplain has been available via communication networks since 1987. Since 1996, access has been provided via the Web, and approximately 46,000 users have logged almost 122,000 sessions. In the last year, 7087 physicians and 2941 medical students have used DXplain. The demonstration will discuss the design goals and user interaction characteristics of DXplain, and will illustrate the use of DXplain with audience participation. Emphasis will be on clinical problem solving issues such as the importance and relevance of different clinical findings in the diagnostic classification of a set of findings. DXplain does not attempt to provide the “correct” diagnosis. The chief goal of DXplain is to interact with the user in the entry of the clinical manifestations and to derive a list of alternative plausible diagnoses.