The recent application of artificial intelligence（AI）to clinical medicine has confirmed the usefulness of AI for diagnostic imaging, histopathological examinations, and dermatologic screening. Clinical decision support systems are another promising area to which AI could contribute toward better clinical decisions. We have developed computer-assisted diagnostic support systems to reduce human diagnostic errors such as delayed diagnoses, misdiagnoses, and overdiagnoses. Our three Diagnosis Reminder（DR）systems include two AI systems that use machine learning in their diagnosis algorithms. Here, we compared the diagnostic accuracy of a DR-supported group with that of an unassisted physicians group, using three difficult patient cases provided by experts in general medicine.
Our analyses revealed that the three AI diagnostic systems could not provide accurate differential diagnoses up to top 10 in all three patient cases because of incomplete data inputs for machine learning. However, the first DR system, which was developed by an experienced diagnostician over the last 35 years, showed very useful performance in reducing human diagnostic errors when it was used by an expert physician. The use of AI diagnostic systems by knowledgeable physicians will lead to better diagnostic performance. We also discuss the current scenario, future challenges, and prospects for AI diagnostic systems herein.
A 78-year-old Japanese woman was referred to our hospital because of fecal occult blood. Barium enema and CT colonography revealed the herniation of the transverse colon and the greater omentum into the right hemithorax through a retrosternal defect. We diagnosed a Morgagni hernia, and we performed a laparoscopic hernia repair with a three-port approach. The invaginated transverse colon and omentum were easily reduced into the abdominal cavity. The size of the hernial orifice was estimated to be approx. 2.5×4 cm. We placed Ventralight ST® mesh over the hernial orifice without hernial sac resection, and we used the double-crown technique to fix the mesh with a hernia stapler. The postoperative course was uneventful, and the patient was discharged on the 5th postoperative day with no complications. There has been no recurrence at 2 years after the surgery. Laparoscopic repair is a safe, less-invasive and useful method for repairing a Morgagni hernia.