Designed by the Laboratory of Computer Science at the Massachusetts General Hospital, work on DXplain began in 1984 with a first version being released in 1986.
[3] The system's large knowledge base combined with its ability to formulate diagnostic hypotheses have made it a popular education tool for US-based medical schools; by 2005, DXplain was supporting more than 33,189 total users.
Analysis of accuracy has shown promise in DXplain and similar clinical decision support systems.
In a preliminary trial investigation of 46 benchmark cases with a variety of diseases and clinical manifestations, the ranked differential diagnoses generated by DXplain were shown to be in alignment with a panel of five board-certified physicians.
[6] In another study investigating how well decision support systems work at responding to a bioterrorism event, an evaluation of 103 consecutive internal medicine cases showed that Dxplain correctly identified the diagnosis in 73% of cases, with the correct diagnosis averaging a rank of 10.7.