A Clinical Decision Support Systems Survey and Evaluation performed by Microsoft Gold Partner, Sagestone, Inc., in 2003 analyzed the five closest competitive Decision Support Software (DSS) solutions available--DXplain, Therapy Edge, Gideon, DiagnosisPro and Quick Medical Reference (QMR)—and concluded that these existing solutions do not completely address diagnostic issues and concerns over information currency and relevancy.  In addition, their target markets are limited in scope or the products themselves are limited in content, usability in normal physician workflow, and accuracy.  The NxOpinion competitive edge incorporates:  

1. Sub-second inference performance across large medical datasets (thousands of diseases and clinical findings).
   
2. Ability to evaluate a combination of the evidence that has been entered against the database of diseases and calculate what evidence, not yet entered or even considered, would have the largest impact on the ranking of the differential diagnosis; guiding the clinician to enter the next most helpful piece of information for the clinical situation. 
3. Optimal usability and interactivity due to Smart Client technology which runs on Desktop, Notebook, TabletPC and PocketPC platforms eliminating the need for a large Web server farm or continuous internet connectivity.
4. Multi-lingual, and Multi-cultural sensitive design.
5. Formula Assistant (wizard that walks the user through the collection of labs that constitute a formula).
6. Exception-based diagnostics which incorporate a data model that looks for the exception to the rule; aiding the diagnosis of unusual presentations of diseases.  It considers statistical sensitivities of clinical findings of a disease, and non-specific, specific and pathognomonic features of a disease allowing for the significance of both absent and present findings.
7. Knowledgebase includes general, specialty, global, chronic and non-chronic diseases using a proprietary knowledge management system eliminating the need for informatics specialists to establish relationships.
8. Continuous knowledgebase review by physicians, nurses, and medical specialists.