Article Text

Download PDFPDF
Rule-based decision support system in the biopsy diagnosis of glomerular diseases
  1. Ruchika Gupta1,
  2. Alok Sharma1,
  3. Sompal Singh2,
  4. Amit K Dinda1
  1. 1Department of Pathology, All India Institute of Medical Sciences, New Delhi, India
  2. 2Department of Pathology, Hindu Rao Hospital, New Delhi, India
  1. Correspondence to Dr Amit K Dinda, Department of Pathology, All India Institute of Medical Sciences, Ansari Nagar, New Delhi 110029, India; amit_dinda{at}


Aims To develop a rule-based decision support system (RDSS) to assist in the diagnosis of glomerular diseases on the basis of clinical, histological and immunohistological findings.

Methods The computer software for the RDSS was written by one of the authors. The prototypical clinical and histomorphological features, including immunofluorescence findings of various glomerular diseases, were selected by three pathologists with experience in renal pathology. For every case included, all the relevant features were fed into the RDSS in the form of one or more vectors. Diagnosis was achieved by the RDSS on the basis of shortest Euclidean distance between the vector of features of a particular ‘test’ case and vectors of the prototypical features. The diagnoses rendered by the RDSS were compared with the final diagnosis signed out by the renal pathologists; the percentage of correct diagnoses was calculated for the RDSS.

Results A total of 612 cases of glomerular diseases were included in the analysis. The RDSS developed in this study gave the correct diagnosis in 83.2% of the cases included. Of all the cases, membranous glomerulonephritis and lupus nephritis were most frequently diagnosed accurately. However, immunotactoid glomerulonephritis was misdiagnosed due to the lack of ultrastructural findings in the study.

Conclusion The decision support system developed in the present study holds promise, given the high accuracy in diagnosis of glomerular diseases on the basis of clinical, histological and immunofluorescence features. Such a system may prove useful not only for diagnosis but also for postgraduate teaching and self-assessment. Results need to be confirmed in further larger studies.

  • Glomerular diseases
  • decision support system
  • Euclidean distance

Statistics from


  • Competing interests None.

  • Provenance and peer review Not commissioned; externally peer reviewed.

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.