The Development of Clinical Decision Support System for Diagnosing Neurogenic Bladder

In this study, we have developed a prototype of clinical decision support systems (CDSS) for diagnosing neurogenic bladder and compared its predicted diagnoses with the actual diagnoses using 92 patient\`s Urodynamic study cases. The CDSS was developed using a Visual Basic based on the evidence-based rules extracted from guidelines and other references regarding a diagnosis of neurogenic bladder. To compare with the 92 final diagnoses made by doctors at the Yonsei Rehabilitation Center, we classified all diagnoses into 5 groups. The predictive rates of the CDSS were: 48.0% for areflexic neurogenic bladder; 60.0% for hyperreflexic neurogenic bladder in a spinal shock recovery stage; 72.9% for hyperreflexic neurogenic bladder, and 80.0% for areflexic neurogenic bladder in a spinal shock stage, which was the highest predicted rate. There were only 2 cases for hyperreflexic neurogenic bladder in a well controlled detrusor activity, and its predictive rate was 0%. The study results showed that CDSS for diagnosing neurogenic bladder could provide a helpful advice on decision-making for doctors. The findings also suggest that physicians should be involved in all development stages to ensure that systems are developed in a fashion that maximizes their beneficial effect on patient care, and that systems are acceptable to both professionals and patients. The future studies will concentrate on including more validating the system.