Neonatal assessment using the Apgar fuzzy expert system.

We applied fuzzy theory to the Apgar scoring system (APG) to devise an Apgar fuzzy expert system (AFES). Three AFESs were determined separately by each one of three doctor groups (four inexperienced obstetricians, four experienced obstetricians and four expert neonatologists) in order to demonstrate that the AFES reflected the examiner's expertise and situation. Two-hundred and sixty-seven neonates were assessed 1 min after birth by an experienced obstetrician using the APG and the three AFESs. Statistical analysis of the relationship between the APG and the three AFESs in the acidosis group showed that the AFES determined by four expert neonatologists had the highest sensitivity and were significantly different (p < 0.05) from the APG. The AFES determined by the four expert neonatologists was revealed to be a valuable tool.