Validating the Accuracy of a Patient-Facing Clinical Decision Support System in Predicting Lumbar Disc Herniation: Diagnostic Accuracy Study.

Abstract

Low back pain (LBP) is a major cause of disability globally, and the diagnosis of LBP is challenging for clinicians. Using new software called Therapha, this study aimed to assess the accuracy level of artificial intelligence as a Clinical Decision Support System (CDSS) compared to MRI in predicting lumbar disc herniated patients. One hundred low back pain patients aged ≥18 years old were included in the study. The study was conducted in three stages. Firstly, a case series was conducted by matching MRI and Therapha diagnosis for 10 patients. Subsequently, Delphi methodology was employed to establish a clinical consensus. Finally, to determine the accuracy of the newly developed software, a cross-sectional study was undertaken involving 100 patients. The software showed a significant diagnostic accuracy with the area under the curve in the ROC analysis determined as 0.84 with a sensitivity of 88% and a specificity of 80%. The study's findings revealed that CDSS using Therapha has a reasonable level of efficacy, and this can be utilized clinically to acquire a faster and more accurate screening of patients with lumbar disc herniation.