By Glenn D. Rennels M.D., Ph.D. (auth.)
As examine on specialist structures has moved good into its moment decade, it has develop into well known to quote the restrictions of the phenomenologic or associational method of wisdom illustration that used to be regular of first new release platforms. for instance, the Internist-1 wisdom base represents explicitly over six hundred illnesses, encoding linked affliction manifestations (signs, indicators, actual findings, and lab abnormalities) yet failing to accommodate the explanations that these findings will be found in the sickness [Miller, R. A. 82]. lately Pople has sought so as to add specified causal versions to the data base in a revised model of this system referred to as CADUCEUS [Pople 82]. equally, a customary construction rule within the MYCIN procedure states inferences that could be drawn while particular stipulations are chanced on to be actual [Buchanan 84], however the underlying causes for such relationships will not be encoded. Clancey has argued that MYCIN wishes such "supporting wisdom" represented, in particular if its wisdom base is for use for educating reasons [Clancey 83]. by means of the overdue Seventies, man made intelligence researchers have been commencing to scan with reasoning platforms that used targeted mechanistic or causal niodels of the item being analyzed. probably the greatest early examples have been a application to coach scholars easy methods to examine digital circuits [Brown eighty two] and a process for diagnosing issues of mechanical units [Rieger 76].
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The need to establish an appropriate focus results because the clinical "consensus" changes over time, as discussed in more detail below. 3. Determine, for each study in the library, whether it can provide experimental results concerning that class of questions. If so, then a. Find the group (stratum) of patients within the study which most closely approximates the physician's patient. b. Identify any experimental results of that stratum which was treated with the interventions of interest (see step 2).
Indeed, how could it be otherwise without knowledge of the problem domain? The job of applying these general "guidelines" in a particular clinical setting rests with the clinician. As a result, Roundsman's knowledge about the studies in its knowledge base contains a significant amount of clinical judgment made by our domain expert. 7. Management of Primary Breast Cancer This section defines medical terms which are necessary to understand the examples found later in the book. The terms pertain to the management of primary breast cancer: treatment options, treatment objectives, and the therapeutic controversies.
Is it correct management to treat for organism-l and not for organism-2? Perhaps not if organism-l causes only discomfort while organism-2 can cause death and the treatment for organism -1 may cause kidney damage. The cost of diagnostic misclassification drives the real-life diagnostic process. Medical cost containment pressures may force more explicit inclusion of cost/benefit considerations in decision support systems as well. Future research is likely to draw upon related disciplines such as operations research which provide a formal theory for evaluating the expected utility of actions.