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Biomedical subjects

L L Weed

Publications and source records attributed to L L Weed.

At least 19 recordsLinked to original sources
PubMed1999

Clinical judgment revisited.

It is widely recognised that accessing and processing medical information in libraries and patient records is a burden beyond the capacities of the physician's unaided mind in the conditions of medical practice. Physicians are quite capable of tremendous intellectual feats but cannot possibly do it all. The way ahead requires the development of a framework in which the brilliant pieces of understanding are routinely assembled into a working unit of social machinery that is coherent and as error free as possible--a challenge in which we ourselves are among the working parts to be organized and brought under control. Such a framework of intellectual rigor and discipline in the practice of medicine can only be achieved if knowledge is embedded in tools; the system requiring the routine use of those tools in all decision making by both providers and patients.

Decision Making, Computer-Assisted↗
PubMed1996

New premises and new tools for medical care and education.

New information tools enable us to leave behind a world of medical practice in which providers of all sorts have been allowed to operate in the face of avoidable ignorance-ignorance of many relevant details from the medical literature as well as ignorance of details about a given patient. Furthermore, the new tools release providers and patients alike from the "predictable and undesirable internal constraints" of the unaided human mind as it tries to process vast amounts of information in the course of everyday medical care.

Computer-Assisted Instruction↗
PubMed1994

Problem knowledge couplers: can they extend our ability to use practice guidelines?

New information tools enable us to leave behind a world of medical practice in which providers of all sorts have been allowed to operate in the face of avoidable ignorance of relevant details from the medical literature as well as details about a given patient. Furthermore, the new tools can assist providers and patients alike in trying to process vast amounts of information in the course of everyday medical care. In the following article, the author discusses some of these new tools and how they can best be utilized.

Communication↗
PubMed1989

The problem-oriented system, problem-knowledge coupling, and clinical decision making.

The information tool to aid us in making the clinical decisions discussed in this presentation is called the PKC. Our goal with patients should be to couple the knowledge of the unique patient to the knowledge in the literature and get the best possible match. This approach requires combinatorial versus probabilistic thinking. In the real world, ideal matches are not found. Therefore, it is critical to exhaust the patient's uniqueness first and only then use probabilities to settle further uncertainties. It is an error to teach people how to deal with uncertainty instead of teaching them to clean up a great deal of the uncertainty first. Patients must be involved in this endeavor. In essence, they have a PhD in their own uniqueness, and it is this uniqueness that is very powerful in solving complex problems. This method of patient evaluation and management cannot be used with the unaided mind. It requires new and powerful information tools like the PKC. All information that is relevant to a problem should be included in the coupler. It should encompass differing points of view, and the rationale should be made explicit to clinician and patient alike. When complete, the coupler should represent an interdisciplinary compilation of questions and tests that are expected to be collected every time in the clinic for the type of problem the coupler represents. This method will provide a basis for quality control because the contents of the coupler now have defined what we expect to occur in every patient encounter.(ABSTRACT TRUNCATED AT 250 WORDS)

Artificial Intelligence↗
PubMed1989

New premises and new tools for medical care and medical education.

Medical care and medical education can be supported more than in the past by using new tools and new premises for the effective linkage between bodies of knowledge and the use of that knowledge. The medical record can be converted from a source-oriented record to a problem-oriented record, enabling to trace not only what was done, but why it was done. These possibilities reveal new insights in the use of databases, problem lists, problem-oriented plans, and problem-oriented progress notes and flowsheets. It brings about a new behavior in teaching which replaces memorizing facts, new possibilities for medical care, and new responsibilities both for physicians and patients. We now have knowledge-coupling tools that can be used directly with the patients at the time of problem solving. Patients are becoming active participants in this process, bringing about new roles for experts as well as expert systems.

Education, Medical↗
PubMed1986

Knowledge coupling, medical education and patient care.

Medical education and the acquisition of professional credentials do not guarantee that medical knowledge (information that is taught, apart from the reality of practice, or gleaned from the literature) will be coupled rigorously to the decision-making process of everyday clinical practice. The limitations of the unaided human mind in a memory-based educational system must be forthrightly acknowledged by those who would be responsible for curriculum reform, so the need for new premises and new tools will be recognized and implemented. Because of their knowledge of the many variables that are unique to them, the patients themselves must be given a much more central role in the process of medical care and medical education. Weaknesses of specialization and credentialing in the present obsolete system are analyzed. The behavior of a well-defined system of education and medical care, and the function of the performers within it, are described. Causes of resistance to curricular reform founded on new premises and use of new tools, such as computers, are considered. New computer tools, as components of a problem-solving decision support system (knowledge couplers, knowledge networks, the coupler editor and documentation system, and the computerized patient record), are described. How these might be incorporated into a new type of medical education curriculum is presented. Finally, new goals, within the context of the new premises being implemented into a new system of education and medical care, are outlined.

Artificial Intelligence↗
PubMed1976

A performance-based method of student evaluation.

A method of medical education has been developed which emphasizes audit of student performance in terms of behavioural traits (thoroughness, reliability, analytic sense, and efficiency) rather than in terms of memorized knowledge. This method is dependent upon the Problem-Oriented Medical Record. The tools developed for the audit and some preliminary results are presented.

Behavior↗