In conclusion, this systematic review shows that the many attempts made for an ideal expert system in rheumatology in the past decades have not yet resulted in convincing validated tools allowing for reliable application in daily practice.Nevertheless,
the demand in support by expert systems is pressing as the knowledge about the rheumatic diseases increases and the therapeutic options especially in early disease stages are growing constantly. An ideal diagnostic expert system in rheumatology would have the following characteristics.The expert system would allow for universal integration into the clinical workflow as well as rapid and intuitive data input. Since rheumatologic diagnoses cannot always be definite, the resulting diagnosis would have a probabilistic
grade to indicate uncertainty.The system would also have an educational component to improve the nonexpert’s ability to recognize pathological findings. Finally, accepted diagnostic criteria sets would be applied to increase the general validity of the system’s diagnostic process. Based on the demand of such a tool and the progress made hitherto it seems to be a matter of time until new and promising expert systems enter clinical practice.