An attempt to simplify clinical diagnostics of poisoning in the field using the binary discrimination method

Introduction. The lack of analytical determination of toxic chemicals in biological environments and environmental objects complicates the assessment of the prognosis of the poisoned person’s condition and the choice of medical tactics at the advanced stages of medical evacuation. This problem is extremely relevant in cases of poisoning with fast-acting substances in conditions where therapeutic measures are severely limited in time. Taking this into account, an attempt was made to develop a diagnostic algorithm based on the mathematical method of binary discrimination of objective signs of poisoning. Material and methods. Tables of 56 bivariantly manifesting (yes/no) signs of 89 etiological types of poisoning were compiled taking into account national guidelines and the authors’ experience in the presence of analytical confirmation of the diagnosis. Using the discriminant binarization method, sets of 11 signs were selected that unambiguously determine all types of poisoning and a decision rule was compiled for their express diagnostics at the advanced stages of medical evacuation. Results. Assessments of the presence or absence of objective manifestations of intoxication in the format of a reduced matrix made it possible to formulate a version of a decision rule for diagnosing poisoning with the most common types of military, industrial and medicinal toxicants, modern narcotic and psychotropic drugs, and substances of natural origin. The compiled algorithm is currently being tested to determine the objective characteristics of prognostic significance in the context of providing medical care of unknown structure toxic agent intoxication. Limitations. Binary discrimination acceptability for data objectification on a probable toxic chemical class does not apply to home foodborne intoxications and iatrogenies, and their methodic interpretabilities are limited by preventive prescription of symptomatic therapeutics. Conclusion. The method of multiple binary discrimination of alternatively expressed features is applicable in the formation of express assessments of the state and prognosis of the course of the disease allows reducing redundant information and compiling primary diagnostic algorithms applicable until analytical confirmation of the etiology of poisoning is available.