ESPRE: a knowledge-based system to support platelet transfusion decisions

ESPRE is a knowledge-based system which aids in the review of requests for platelet transfusions in the hospital blood bank. It is a microcomputer-based decision-support system written in Lisp and utilizes a hybrid frame and rule architecture. Most of the required patient data is automatically obtained directly from the hospital´s main laboratory computers via a direct link, so that very little keyboard entry is required. Assessment of time trends computed from the data constitutes an important aspect of this system. To aid the blood bank personnel in deciding on the appropriateness of the requested transfusion, the system provides an explanatory report which includes a list of patient-specific data, a list of the conditions for which a transfusion would be appropriate for the particular patient (given the clinical condition), and the conclusions drawn by the system. In an early clinical evaluation of ESPRE, out of a random sample of 75 platelet transfusion requests, there were only three disagreements between the ESPRE and blood-bank personnel.