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Graber’s article raises several valid points about the provision of diagnostic decision support in the Emergency Department (ED).1 The ED is one setting where reaching the correct diagnosis (for simple clinical problems as well as unusual ones) may reduce the burden of diagnostic error and its costly adverse consequences.2
In Graber’s study, QMR and ILIAD were tested for their diagnostic accuracy with the limited amount of data available at initial clinical presentation; quite rightly, the authors used the final diagnosis at discharge from ED as the gold standard. However, this testing was not performed by the lay user, and the systems were provided detailed …