The Isabel Differential Diagnosis Generator for Orbital Diagnosis.

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  • Additional Information
    • Source:
      Publisher: Lippincott Williams & Wilkins for the American Society of Ophthalmic Plastic and Reconstructive Surgery Country of Publication: United States NLM ID: 8508431 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1537-2677 (Electronic) Linking ISSN: 07409303 NLM ISO Abbreviation: Ophthalmic Plast Reconstr Surg Subsets: MEDLINE
    • Publication Information:
      Publication: 199 - : Hagerstown, MD : Lippincott Williams & Wilkins for the American Society of Ophthalmic Plastic and Reconstructive Surgery
      Original Publication: [New York, NY : Raven Press Publishers], c1985-
    • Subject Terms:
      Graves Ophthalmopathy*/diagnosis ; Exophthalmos*/etiology ; Orbital Diseases*/diagnosis ; Orbital Diseases*/complications ; Orbital Neoplasms*/diagnosis ; Orbital Neoplasms*/complications ; Eyelid Diseases*/diagnosis; Humans ; Diagnosis, Differential ; Orbit/diagnostic imaging ; Orbit/surgery
    • Abstract:
      Purpose: The Isabel differential diagnosis generator is one of the most widely known electronic diagnosis decision support tools. The authors prospectively evaluated the utility of Isabel for orbital disease differential diagnosis.
      Methods: The terms "proptosis," "lid retraction," "orbit inflammation," "orbit tumour," "orbit tumor, infiltrative" and "orbital tumor, well-circumscribed" were separately input into Isabel and the results were tabulated. Then the clinical details (patient age, gender, signs, symptoms, and imaging findings) of 25 orbital cases from a textbook of orbital surgery were entered into Isabel. The top 10 differential diagnoses generated by Isabel were compared with the correct diagnosis.
      Results: Isabel identified hyperthyroidism and Graves ophthalmopathy as the leading causes of lid retraction, but many common causes of proptosis and orbital tumors were not correctly elucidated. Of the textbook cases, Isabel correctly identified 4/25 (16%) of orbital cases as one of its top 10 differential diagnoses, and the median rank of the correct diagnosis was 6/10. Thirty-two percent of the output diagnoses were unlikely to cause orbital disease.
      Conclusion: Isabel is currently of limited value in the mainstream orbital differential diagnosis. The incorporation of anatomic localizations and imaging findings may help increase the accuracy of orbital diagnosis.
      Competing Interests: The authors have no financial or conflicts of interest to disclose
      (Copyright © 2023 The American Society of Ophthalmic Plastic and Reconstructive Surgery, Inc.)
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    • Publication Date:
      Date Created: 20230317 Date Completed: 20231102 Latest Revision: 20240207
    • Publication Date:
      20240207
    • Accession Number:
      10.1097/IOP.0000000000002364
    • Accession Number:
      36928323