Diagnosis of rheumatism by means of universal criteria, obtained by the cybernetic method

Abstract

With a view to establishing standardized criteria for the diagnosis of rheumatism suitable for widespread use in polyclinics and in large-scale epidemiological investigations, 3000 adults and children with rheumatism or one of seven similar diseases were subjected to multiple screening in eight centres in the USSR using a specially prepared standard card and standard methods. The information obtained was processed by cybernetic methods. Following determination of the sensitivity, specificity, and informational value of 486 signs of rheumatism, 68 of the most indicative signs were selected as criteria of rheumatism. These were included in the final table and weighted according to their indicational value both individually and in groups as syndromes. Using the table it is possible by simple calculation, without using a computer, to arrive at an objective evaluation of the reliability of the clinical diagnosis of rheumatism in patients with one of a group of eight similar diseases. The final diagnostic table was tested on 562 patients selected epidemiologically or from polyclinics or clinics and was shown to result in a high degree of diagnostic precision (higher than 95%).