[Computerized management of therapy protocols in oncology. Evaluation of a decision support for breast carcinoma].

A computerized system for assisted clinical decisions in breast cancer was evaluated, comparing the therapeutic strategies suggested bt the program with those actually used in an oncology Division. One hundred patients treated at the Medical Oncology Department of the National Institute for Cancer Research of Genoa, Italy, were entered into the study. Results, showing a 95% concordance, are discussed.

[A comparative evaluation of computerized diagnostic decisional support in gastroenterology in relation to typical clinical pictures].

On the basis of the results obtained in a previous perspective comparative study aimed to compare the diagnostic accuracy of a computerized diagnostic decisional support in gastroenterology with that of non-specialist physicians, the Authors have carried out a retrospective study, based on the same series and on the same results, but disaggregating the global comparisons according to the feature of the clinical presentations. The latter were therefore classified by independent gastroenterologists as "typical", "atypical", or "borderline", and for each group the difference of diagnostic accuracy between program and physicians was again evaluated. Even if the program proved more accurate in all groups, the greatest difference was observed in the "borderline" group which the Authors claim to include the kind of presentation which more than any other needs a decisional aid.

Effect of timepidium bromide on the motor activity of the sphincter of Oddi: manometric evaluation of intracholedochal pressure.

The intracholedochal pressure changes induced by timepidium bromide were studied in 12 patients who had undergone surgery because of gall bladder stones and were receiving transient external bile drainage by the Kehr method. Cholangiomanometric examination, carried out under basal conditions and after an intravenous dose of 15 mg timepidium bromide, revealed a statistically significant decrease in mean intracholedochal pressure in all 12 patients. It is concluded that timepidium bromide is likely to exert a direct action on the sphincter of Oddi, decreasing its basal tone and thus causing a decrease in intracholedochal pressure.

Clinical application of a computerized diagnostic aid in the initial evaluation of 250 outpatients with gastrointestinal complaints.

The results of a prospective controlled study designed to evaluate the performance of a computerized diagnostic aid in the clinical setting are reported herein. Two hundred and fifty patients referred to an outpatient clinic for gastrointestinal complaints were entered into the study. The diagnostic aid program was used routinely and the findings elicited from patients' medical histories and physical examinations were entered into the computer at the time of initial evaluation.