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Algorithm Bests MDs at Documenting 'Red Flags'

A computer algorithm did a better job than doctors at documenting "red flag" symptoms among patients with gastrointestinal disorders, a Cedars-Sinai study has found, underscoring the potential of the technology to improve patient care.

The algorithm, developed by investigators at Cedars-Sinai's Center for Outcomes Research and Education, identified more "alarm features" than did doctors who treated patients in GI clinics. The computer program also provided useful details about the onset, frequency and amount of symptoms such as blood in the stool or unintended weight loss.

Investigators said their findings, published online by the International Journal of Medical Informatics, demonstrate how computers can complement — rather than replace — physicians in the exam room. The researchers explained that a red flag "checklist" of symptoms could serve as a useful tool to inform doctor-patient consultations.

"In essence, this system could help doctors provide better care for their patients by identifying illnesses at earlier stages and providing treatment sooner," said Christopher V. Almario, MD, MSHPM, the study's lead author and a research scientist in the outcomes research center.

The study said that GI doctors may be underreporting red flag symptoms partly because physicians with other clinical and administrative tasks don't have enough time to fully inquire about symptoms with each patient. The study did not say whether improved identification of symptoms leads to better patient outcomes.

This is the second study from the Cedars-Sinai research center into the use of computers as a tool for clinical care. A companion study last year showed that the same algorithm was more effective than doctors at creating complete and organized patient medical histories.

Both studies drew on the same group of patients with a variety of active GI symptoms, including abdominal pain, heartburn, reflux, nausea, vomiting, constipation and diarrhea. For the studies, patients initially visited doctors and later answered questions about their conditions on a website called My GI Health.

The investigators said the pair of studies highlights the enormous potential of computers to give doctors a valuable hand with patients.

"This is where digital health is at its best, by offering a simple yet compelling way to take better care of patients," said Brennan Spiegel, MD, MSHS, director of Cedars-Sinai Health Services Research and director of the Center for Outcomes Research and Education. "Patients want to know that their doctor will ask all the right questions and detect anything serious. But sometimes even doctors need digital aides to support their knowledge and intuition."