Knowledge-based interpretation of serologic tests for hepatitis on the World Wide Web.

HEPAXPERT is a knowledge-based system that interprets the results of routine serologic tests for infection with hepatitis A and B viruses. The following tests are included: hepatitis A virus antibodies, IgM antibodies to the hepatitis A virus, hepatitis A virus in stool, hepatitis B surface antigen and antibodies, antibodies to hepatitis B core antigen, and hepatitis B envelope antigen and antibodies. HEPAXPERT/WWW, an implementation of HEPAXPERT-III for the World Wide Web, can be reached by URL http://www.med-expert.co.at/hepax. After selecting HEPAXPERT/WWW, serologic test results can be entered and will be transferred as an E-mail message for subsequent interpretation, which is done off-line with HEPAXPERT-III. The textual interpretation is sent back via E-mail. Each qualitative test for hepatitis A and B antibodies and antigens may produce one of four possible results: positive, negative, borderline, and not tested. To cover the resulting 64 (A) and 57,344 (B) combinations of findings, the knowledge base of HEPAXPERT/WWW contains 16 rules of hepatitis A and 131 rules for hepatitis B serology interpretation. This basic knowledge is structured such that all possible combinations of findings can be interpreted, and there is no overlap in the premises underlying the rules. The reports that the system automatically generates include the transferred results of the tests; a detailed analysis of the results, including virus exposure, immunity, stage of illness, prognosis, infectiousness, and vaccination recommendation; and, as an option, an identification, to distinguish the origin of the interpretation requests.

A WWW-accessible knowledge base for the interpretation of hepatitis serologic tests.

HEPAXPERT is a knowledge-based system that interprets the results of routine serologic tests for infection with hepatitis A and B viruses. The following tests are included: hepatitis A virus anti-bodies (anti-HAV), IgM antibodies to the hepatitis A virus (IgM anti-HAV), hepatitis A virus (HAV in stool, hepatitis B surface antigen (HBsAg) and antibodies (qualitative anti-HBs, quantitative anti-HBs titre), antibodies to hepatitis B core antigen (anti-HBc and IgM anti-HBc), and hepatitis B envelope antigen (HBeAg) and antibodies (anti-HBe). HEPAXPERT/WWW--an implementation of HEPAXPERT-III for WWW--can be reached by URL http://www.swun.com/hepax of the World Wide Web. After selecting HEPAXPERT/WWW, serologic test results can be entered and will be transferred as an e-mail message for subsequent interpretation which is done off-line with HEPAXPERT-III. The textual interpretation is sent back via e-mail. Each qualitative test for hepatitis A and B antibodies and antigens may produce one of four possible results: positive, negative, borderline, and not tested. To cover the resulting 64 (A) and 57344 (B) combinations of findings, the knowledge base of HEPAXPERT/WWW contains 16 rules for hepatitis A and 131 rules for hepatitis B serology interpretation. This basic knowledge is structured such that all possible combinations of findings can be interpreted and there is no overlap in the premises underlying the rules. The reports that the system automatically generates include: (a) the transferred results of the tests; (b) a detailed analysis of the results, including virus exposure, immunity, stage of illness, prognosis, infectiousness, and vaccination recommendation; and (c) optional: an ID to distinguish the origin of the interpretation requests.

HEPAXPERT-III: knowledge-based interpretation of serologic tests for hepatitis A, B, C, and D.

1. The HEPAXPERT-III SYSTEM. HEPAXPERT-III--the successor of HEPAXPERT-I[1] and HEPAXPERT-II [2]--is a routinely-used, integrated medical database and knowledge-based system that stores and interprets the results of serologic tests for infection with hepatitis A, B, C, and D viruses. The following tests are included: Anti-HAV, IGM anti-HAV, and HAV in stool; HBsAg, anti-HBs, anti-HBc, IGM anti-HBc, HBeAg, anti-HBe, and anti-HBs titre; Anti-HCV, HCV-immunoblot, and HCV-PCR; Delta-Ag and anti-delta. HEPAXPERT-III provides the following functions: a) screen input of patient's personal data (patient ID, surname, first name, name at birth, date of birth, and sex), administrative data (department requiring the tests and date of specimen sample), and medical data (results of serologic tests); and/or b) automatic transfer of patient's personal, administrative, and medical data by connecting HEPAXPERT-III to a laboratory information system, a hospital information system, or an automated laboratory analyzer; and c) automatic generation of interpretive reports of the obtained serologic findings, including an analysis of possible virus exposition, immunity, disease stage, prognosis, and degree of infectiousness. HEPAXPERT-I and HEPAXPERT-II have been routinely used at the Vienna General Hospital, the teaching hospital of the University of Vienna Medical School. The interpretive reports are well-accepted and lead to several improvements in patient care [3]. HEPAXPERT-III will not only extend the scope of interpretation to hepatitis C and D serologic tests, but will also offer a state-of-the-art graphical user interface. 2. HARDWARE AND SOFTWARE. IBM-compatible personal computer (minimum 80386 SX processor), 8 MB RAM (OS/2) and 4 RM RAM (MS-Windows), resp., graphic adapter (minimum 640x480) and printer supported by OS/2 and MS-Windows 3.1, resp., IBM OS/2-2.1 or higher and MS-Windows 3.1 or higher, resp., and for the OS/2 version IBM Database 2 (DB2/2).