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 2433_files/spacer.gif) GIDEON: Global Infectious Disease and
Epidemiology Network
one
CD-ROM, requirements: Windows 95/98/NT, CD drive (for installation
and updates), 486 processor (Pentium recommended), 20 MB disk space,
16 MB RAM. 4 CDs annually, San Francisco, Calif, http://www.gideononline.com/,
CY Informatics, 2001.
JAMA. 2002;287:2433-2434.
It is
always reassuring to find that good things last, pleasing
to find they sometimes actually improve over time, and
totally unexpected when they become less expensive. Such
is the case for GIDEON: Global Infectious Disease and
Epidemiology Network. When I first reviewed it for
JAMA in 1994, I described GIDEON as an
intellectual tour de force that operated in the simplest
fashion. It still is, but it has been further improved
with time.
GIDEON is a computer program that provides remarkable
assistance in diagnosing infectious diseases. No ordinary
artificial intelligence program, GIDEON deals with
infectious diseases on a worldwide basis, country by
country. At a time when immigration from remote countries
and adventure travel are increasingly common, this
feature becomes quite important. GIDEON incorporates
every major and minor infectious disease that has been
described: bacterial, viral, protozoan, parasitic, and
fungal infections, from Acanthamoeba
meningoencephalitis and Astrakhan fever, through
Mycobacterium and Mycoplasma, to
Yersinia and zygomycosis.
One begins by entering clinical symptoms and signs into a
structured query. Country (or countries) of exposure is
entered next. After sufficient clinical information has
been entered, GIDEON lists potential diagnoses by
order of probability. Understanding that there are plenty
of infectious diseases with which we are all unfamiliar,
there are windows that open describing each disease,
clinical picture, cause, geographic distribution, and
details of vehicle, vector, incubation, and treatment. It
is easy to change any of the signs or symptoms that are
in doubt, thereby assessing the effect of clinical
uncertainty on diagnosis. An enormous mass of information
is available in the most straightforward manner simply by
opening the relevant window. The concept underlying this
artificial intelligence program is grand, but its execution
is simple.
A similar scheme of using microbiological characteristics is
available to help in the laboratory identification of
microbial pathogens. The antimicrobial drug database is
valuable in its own right and includes information on
dosage, drug interactions, and side effects. Another
useful window presents information about all existing
vaccines, their use, and their side effects.
GIDEON provides all this with remarkable clarity and
ease of use.
In addition to upgrading the original program to its current
version, the information base is updated four times
yearly. One buys a year's subscription, not a single
copy, for $895. And, ingeniously, rather than leaving the
basis for considering purchase to the mercy of reviewers,
GIDEON now has a demonstration at the Web site: http://www.gideononline.com/
or http://www.cyinfo.com/.
A tutorial walks one through the entire program,
illustrating its various components in operation,
including the new bioterrorism module. The demonstration
is as impressive as the program itself.
GIDEON is the epitome of its genre. If you are a clinician
having any contact with infectious diseases, working in a
microbiology laboratory, or with interest in artificial
intelligence as applied to medical diagnosis, the Web
site for the Global Infectious Disease and
Epidemiology Network is worth examining. This important
program deserves widespread attention.
Vincent J. Felitti, MD, Reviewer Kaiser
Permanente Medical Care Program San Diego, Calif
Books, Journals, New Media Section Editor: Harriet S.
Meyer, MD, Contributing Editor, JAMA; David H. Morse, MS,
University of Southern California, Norris Medical Library, Journal
Review Editor; adviser for new media, Robert Hogan, MD, San
Diego.
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