Tool for physicians, residents: Isabel Pro helps diagnose complex cases

By Faith Harper, Office of Public Affairs

Isabel ProUTHealth Houston has a tool to assist physicians and residents when diagnosing patients with challenging symptom presentations or those who have not responded to treatment.

This computer and mobile resource, called Isabel Pro, can be found through a link on the Epic electronic health record system, which will also display a QR code to download the proper mobile version to their mobile devices.

The system is easy to use, requires minimum input, and produces a well-researched differential diagnosis listing in seconds. It offers the prospect of reducing missed diagnostic opportunities.

Each year, studies estimate that about 5% of patients are misdiagnosed, equating to roughly 1 in 20 patients, according to the National Academy of Medicine. Those misdiagnoses can have serious impacts on a patient’s well-being and long-term health, even resulting in patient harm. Isabel Pro can be helpful in helping provide options for complex cases.

Preliminary research suggests the system can improve accuracy of diagnosis by an absolute 5% even among the most experienced diagnosticians, and is particularly helpful when diagnosing geriatric patients, who often have numerous comorbidities. Isabel Pro is presently in use in primary care and internal medicine practices, as well as for McGovern Medical School at UTHealth Houston internal medicine residents, but it is available to any physician with access to the Epic EHR.

The program is a computerized diagnostic decision support system covering more than 10,000 conditions for all ages and specialties. Using a patient’s age, sex, region, and clinical features, Isabel Pro produces a relevant, rank-ordered differential diagnosis listing for consideration by the physician. Input takes less than two minutes, with the differential produced immediately.

The ranked differential presents in the order in which the patient’s clinical features match the scientific literature for the listed condition. UpToDate is one of the reference sources used to research a specific condition. Isabel Pro will produce a differential listing of relevant diagnoses with the option, without reentering any data, to research each diagnosis using UpToDate, the Merck Manual, Google, PubMed, or other well-researched resources.

Isabel Pro also is the subject of a study to assess the utility of diagnostic decision support in routine clinical practice. A brief questionnaire scheduled for the end of February 2022 will seek users’ opinions following their use of the system in their practice.

For questions about the system or the study, contact Joe M. Bridges, doctorate of health informatics program candidate at UTHealth Houston School of Biomedical Informatics at