This Concerted Action has dealt with Objective Medical Decision Making in relation to Acute Abdominal Pain. Over 450 clinicians and scientists in 64 institutions in 19 different countries have participated in a network of collaborating centres, along with input from 18 national and international societies. Agreement has been reached (after wide consultation with the above participants) concerning a minimum dataset of information to be collected from patients presenting to hospital with acute abdominal pain, together with definitions of terminology for each clinical feature and criteria for diagnosis of each specific disease. On this basis a data collection instrument (a structured proforma) has been developed and translated into most major European languages for the purposes of quality controlled, reproducible data collection.

Using the above, a database of clinical information, strictly controlled for quality, concerning 15,000 acute abdominal pain cases, has been collected. This dataoase, in its scope, extent, and quality control, is unique.

Immediate benefits have occurred within the institutions participating in the project. There is evidence that institutions associated with the project have (when compared with unaided baseline or national figures) achieved the following benefits:- * Reduction of residual diagnostic error rate by 40% * Reduction in unnecessary operation rate by two fifths * Reduction in perforation rate in appendicitis cases by half.

Longer term benefits have either been obtained or are now available for the European Community in terms of:- The existence of an agreed reproducible terminology for the disease area (acute abdominal pain) in question; the creation of a “language independent” computer program to aid objective medical decision-making and clinical audit; the development of an EC wide multinational research team from groups of scattered workers; the creation and distribution of decision-support materials, structured proformata, teaching video-tapes and computer programs widely throughout the EC: the availability of a database of information, strictly controlled for quality, for further clinical research and for evaluation of further decision-support technology in the future.