Saturday , June 23 2018

A Computer-based Decision Support System Used in Identifying Relationship between Oral Symptoms and Systemic Diseases

Dana GHIGA1, Marius PETRIŞOR2, Anca BACÂREA3, Vladimir C. BACÂREA1, Marius Ş. MĂRUŞTERI2, Bogdan A. HAIFA2,  Dan Ş. SÎMPĂLEAN2, Alexandru Şchiopu3
1 Department of Medical Research Methodology,
University of Medicine and Pharmacy
38, Gh. Marinescu Street, Târgu Mureş, 540000, Romania

2 Department of Medical Informatics and Biostatistics,
University of Medicine and Pharmacy
38, Gh. Marinescu Street, Târgu Mureş, 540000, Romania

3 Department of Pathophysiology,
University of Medicine and Pharmacy,
38, Gh. Marinescu Street, Târgu Mureş, 540000, Romania

Abstract: The aim of this study is to present a dental patient management software application module that offers the possibility to record the oral symptoms of systemic diseases and presents a presumptive diagnosis. We implemented a web application for patients’ management in the dental office which includes such a module that besides presenting a presumptive diagnosis also provides detailed information regarding the disease and the recommended laboratory investigations. The implemented software application allows the selection of the oral lesions revealed during intraoral examination and once the oral lesion has been selectedthe application displays the list of the systemic diseases which presents the selected oral lesion as an oral symptom. After displaying the probable systemic diseases, the user can learn more information about a particular disease by clicking on its label. An innovative aspect of the proposed application is the existence of the module that allows the presumptive diagnosis of a systemic disease by selecting the oral lesions found during intraoral examination. Also the software application offers information regarding the selected systemic disease etiology, oral signs and symptoms and the laboratory investigations required for the final diagnosis.

Keywords: Oral manifestations, disease, computer-assisted diagnosis.

>>Full text
Dana V. GHIGA, Marius D. PETRIŞOR, Anca BACÂREA, Vladimir C. BACÂREA, Marius Ş. MĂRUŞTERI, Bogdan A. HAIFA, Dan Ş. SÎMPĂLEAN, Alexandru ŞCHIOPU, A Computer-based Decision Support System Used in Identifying Relationship between Oral Symptoms and Systemic Diseases, Studies in Informatics and Control, ISSN 1220-1766, vol. 21 (3), pp. 267-274, 2012.

1. Introduction

The use of computers to help health professionals in their work has been studied since the 1950s [1]. Initially, efforts were focused on developing diagnostic systems [2]. Ledley and Lusted [3] were the first to have addressed this possibility. They described the use of punch cards to indicate the relationship between diseases and their manifestations. An experimental prototype was described in a later publication [4]. Issues related to limitations of scientific basis and reluctance by practitioners to accept a system that was not integrated into regular workflow prevented the establishment of the system on large scale [5].

In the last decadescomputers have been introduced in the medical field, but in recent years scientists are trying to make the use of computers more efficient by developing a variety of applications including image analysis [6], color analysis as an alternative to the spectrophotometer [7],hospital management integrated solutions. The use of a computer has also become mandatory in the dental office.

Nowadays, a computer with Internet access has become an essential tool in the dental office.

In dental practice, in order to improve health care, numerous software applications have been developed with the most varied uses, from “simple” data storage to processing and analysis or three-dimensional reconstruction and simulation. Nowadays, for almost every clinical and technological phase, there is a computerized system which serves the physicians or the technicians in their work.

Currently available systems do not offer any possibility of recording the oral lesions that may be present in the oral cavity, due to systemic disease.

Many problems in dental practice are not trivial or simple, and therefore require rigorous research efforts. Without well-founded methodological approaches, computer technology will not achieve the expected performances, those of helping the physicians and patients.

Integrated computer systems, must be designed around the work of medical staff and should allow them to better focus on patient care. Such systems must provide information when and where necessary, minimize duplication of data entry and their indirect and should be easy to use.

The aim of this study is to present a module from a patient management software application in the dental office that offers the possibility of recording the oral symptoms of systemic diseases and presenting a presumptive diagnosis.


  1. MENDONÇA, E. A., Clinical Decision Support Systems: Perspectives in Dentistry. Journal of Dental Education, vol. 68(6), 2004, pp. 589-597.
  2. MILLER. R. A., Medical Diagnostic Decision Support Systems – Past, Present, and Future: A Threaded Bibliography and Brief Commentary. Journal of American Medical Informatics Association, vol. 1(1), 1994, pp. 8-27.
  3. LEDLEY, R. S., L. B. LUSTED, Reasoning Foundations of Medical Diagnosis, Science, vol. 130, 1959, pp. 9-21.
  4. WARNER, H. R., A. F. TORONTO, L. VEASY, Experience with Baye’s Theorem for Computer Diagnosis of Congenital Heart Disease. Annals of the New York Academy of Science, vol. 115, 1964, pp. 2-16.
  5. MUSEN, M. A., Y. SHAHAR, E. H. SHORTLIFFE, Clinical Decision-Support Systems, in Shortliffe E. H., Perreault L. E, Wiederhold G, Fagan L. M, eds. Medical informatics: computer applications in health care and biomedicine. 2nd ed. New York, Springer-Verlag, 2001, pp. 573-609.
  6. CHIOREAN, L., L. SUTA, M. VAIDA, M. HEDESIU, Medical Fusion Components for a Web Dedicated Application, SIC, vol. 19(4), 2010, pp. 435-444.
  7. HAIFA, B., V. BACÂREA, O. IACOB, T. CĂLINICI, A. ŞCHIOPU, Comparison between Digital Image Processing and Spectrophotometric Measurements Methods. Application in Electrophoresis Interpretation, Applied Medical Informatics, vol. 28(1), 2011, pp. 29-36.
  8. MUJI, M., R. V. CIUPA, D. DOBRU, C. BICA, P. OLAH, V. BACAREA, M. MARUSTERI, Database Design Patterns for Healthcare Information Systems, International Conference on Advancements of Medicine and Health Care Through Technology, vol. 26, 2009, pp. 63-66.
  9. U.S. Department of Health and Human Services. Oral Health in America: A Report of the Surgeon General. Rockville, MD: U.S. Department of Health and Human Services, National Institute of Dental and Craniofacial Research, National Institutes of Health, 2000.
  10. ISLAM, N. M., I. BHATTACHARYYA, D. M. COHEN, Common Oral Manifestations of Systemic Disease. Otolaryngologic Clinics of North America Oral Medicine, vol. 44(1), 2011, pp. 161-182.
  11. WHITE, S. C., Decision-support systems in dentistry. Journal of Dental Education, vol. 60(1), 1996, pp. 47-63.
  12. SONG, M., H. SPALLEK, D. POLK, T. SCHLEYER, T. WALI, How Information Systems should Support the Information Needs of General Dentists in Clinical Settings: Suggestions from a Qualitative Study. BMC Medical Informatics and Decision Making, vol. 10, 2010, pp. 7-16.
  13. THYVALIKAKATH, T. P., V. MONACO, H. B. THAMBUGANIPALLE, T. SCHLEYER, A Usability Evaluation of Four Commercial Dental Computer-based Patient Record Systems. JADA, vol. 139(12), 2008, pp. 1632-1642.
  14. ELTING, L. S., C. G. MARTIN, S. B. CANTOR, E. B. RUBENSTEIN, Influence of Data Display Formats on Physician Investigators’ Decisions to Stop Clinical Trials: Prospective Trial with Repeated Measures. BMJ, vol. 318(7197), 1999, pp. 1527-1531.
  15. NYGREN, E., J. C. WYATT, P. WRIGHT, Helping Clinicians to Find Data and Avoid Delays. Lancet, vol. 352(9138), 1998, pp. 1462-1466.
  16. PRATT, W., M. C. REDDY, D. W. MCDONALD, P. TARCZY-HORNOCH, J. H. GENNARI, Incorporating Ideas from Computer-supported Cooperative Work. Journal of Biomedical Informatics, vol. 37(2), 2004, pp. 128-137.
  17. SUDUC, A.-M., M. BÎZOI, L. DUŢĂ, G. GORGHIU, Interface Architecture for a Web-Based Group Decision Support System, SIC, vol. 18(3), 2009, pp. 241-246.
  18. VIKRAM, K., F. R. KARJODKAR, Decision Support Systems in Dental Decision Making: An Introduction, Journal of Evidence Based Dental Practice, vol. 9(2), 2009, pp. 73-76.