Dr. Hudgins is a Board Certified neurosurgeon now retired from practice. Click here to see his Résumé and list of professional publications.
In 1970 Dr. Hudgins published results of his two-year clinical evaluation of several hundred patients hospitalized with low back pain and he then introduced the use of calculating the predictive value (PV) from 10-90%, of myelography in diagnosing a disc protrusion in the lower back, (ref.17). The development of imaging scans and personal computing allowed him to upgrade that study to a computer program that included CT and MRI scans and could do the math calculations automatically. This program, called LOBAK, was accepted for presentation at a Symposium on Artificial Intelligence at the National Computer Conference in 1981 (ref.36).
LOBAK uses results of operative and non-operative treatments for lumbar disc protrusions in a decision analysis calculation to see if the PV exceeds the diagnostic threshold for having a disc protrusion that indicates a better outcome with surgery (ref.10). Programs such as LOBAK aren’t true artificial intelligence and have become known as computer-assisted medical decision-making (CMD). Hudgins did test LOBAK’s validity by giving the medical records of 10 patients, without the diagnosis and treatment plans, to 10 physicians (four spine specialists and six non-specialists) for evaluation. The 10 test cases were; spine tumor, spinal stenosis, four patients with a herniated lumbar disc in various locations, arthritis, back strain, no herniated disc, and post-traumatic pain. These evaluations were compared to LOBAK’s output. All of the doctors considered LOBAK’s results to be acceptable or an acceptable alternative to their diagnosis and management plans, except in one case (ref. 39).
Note: LOBAK only makes suggestions for a physician’s consideration. A doctor’s clinical judgment should always supercede CMD. Furthermore, in many lumbar disc cases the problem is mainly pain and the patient has the right to choose a treatment or no treatment at all, particularly when surgery is recommended. You can see the full Liability Disclaimer here.