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JAMA 2002

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Vol. 287 No. 18, May 8, 2002 – Felitti 287 (18) 2433

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.

© 2002 American Medical Association. All Rights Reserved.

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