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PubMedDate not supplied

Stabilizing blood glucose with a novel medical expert system.

In health, metabolism is elegantly coordinated. Failure of an underlying process (as occurs in diabetes) disrupts the coordination and impacts on the global status of the affected individual. It takes a medical expert to intervene and restore order. Chaotic processes prevail at all times in biological systems and their behaviour in sickness degenerates between medical interventions. We have explored the use of an expert system to substitute for the physician between interventions and demonstrated its ability to maintain order and thus significantly improve control of blood glucose.

Adolescent↗
PubMedDate not supplied

Expert system support using Bayesian belief networks in the prognosis of head-injured patients of the ICU.

The present study concerns the construction and operation of a Bayesian analytical system, namely a Bayesian belief network (BBN) for the prognosis at 24 h of head-injured patients of the intensive care unit. The construction of a BBN incorporates the maintenance of a large database including all the critical variables corresponding to the specific clinical domain. This database is processed to provide the necessary libraries of conditional probability values. BBNs permit the combination of prognostic evidence in a cumulative manner and provide a quantitative measure of certainty in the final decision. The user views the changes at each step, thus being capable of deciding upon the necessary pieces of information in order to reach a certain belief threshold. The system produces results that are compatible with the opinions of medical experts regarding the prognosis of patients exhibiting certain patterns of clinical or laboratory data.

Adult↗
PubMed2001

Expert systems, security and quality assurance: implications of patient records as data-space.

The concept of data-space is fruitful in trying to understand the ethical rights and duties that surround the treatment of patient records. However, it also provides a solution to three apparently unconnected problems: the construction of expert diagnostic systems, the development of an internal security element within the sphere of permitted data-access for health care professionals, and the development of a professional quality assurance mechanism. This paper presents a model of how these diverse aims may be achieved. It does so by developing the notion of the logical form of data within a data-space and by showing how the path taken by a health care professional through a profession-relative data-space can provide checks for the security, quality and appropriateness of the path itself. The result is important in that it provides an integrated method for information specialists to meet their fiduciary obligations towards the patients whose records are in their care, and towards the institutions that employ them.

Computer Security↗
PubMed1989

Evaluation issues in the development of expert systems in medicine.

Evaluation of medical decision support software (MDSS)--computer programs to assist health professionals with diagnostic and/or therapeutic decisions--has not kept pace with the development of such programs. This article describes the following formative evaluation issues that must be addressed by developers of MDSS to evaluate these programs properly: (1) How can systematic feedback be obtained about an evolving program? (2) How can enough data to evaluate the program be obtained? (3) How much instruction is necessary? (4) What are the most important aspects for users to evaluate? and (5) How can the appropriate use of a developing MDSS be assured? Data from an ongoing evaluation of an existing MDSS, Quick Medical Reference, are used to illustrate the issues and to suggest recommendations for addressing them.

Data Collection↗