Field Evaluations of a Knowledge-Based System for Peripheral Blood Interpretation

A medical knowledge-based system for hemogram and peripheral blood smear interpretation was tested in three situations outside of the developers' laboratory: Coulter Corporation's Clinical Evaluations, and two clinical laboratories in the United States and Canada. Rigorous testing of the system's functionality was performed. Hazard testing caught several programming errors which were corrected. The outside evaluators requested a number of changes to the screens and additional functionality. As a result, several user configurable features were added to the system. Medical information collected from 13 of 392 (3.3%) cases effected the knowledge base. Only two of the evaluator's comments concerned the style of the system's displayed output. The system was able to maintain high quality interpretive reports, appropriate to patient care, despite the expected differences in subjective morphologic interpretation between observers.