Keywords
Clinical decision support system
thyroid
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Abstract
Objective: To present the creation process and preliminary validation of a clinical decision support system (CDSS) for the management and referral of patients with thyroid nodules to be used in primary care Methods: The knowledge based CDSS was built using rules derived from Brazilian and international specialized technical guidelines, using the decision tree technique. For preliminary validation, we used a pilot sample of 31 patients with thyroid nodules treated at an endocrinology outpatient clinic, with their data entered into the SADC and subsequent comparison between the decision suggested by the system and a reference decision proposed by specialist physicians. Three performance metrics (accuracy, sensitivity and specificity) were calculated, as well as the Kappa coefficient of agreement between decisions Results: The CDSS accuracy was 90.3%, with 90% sensitivity and 90,5% specificity. Kappa coefficient of agreement was 0.78 with 95% CI (0.5 - 1.01). Conclusion: The proposed CDSS presented a good result in performance metrics and an agreement interpreted as substantial according to the Kappa coefficient.
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