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A decision support system for artificial ventilation is being developed. One of the fundamental goals for this system is the application of the system when a domain expert is not present. Such a system requires a rich knowledge base. The knowledge acquisition process is often considered to be the bottleneck in acquiring such a complete knowledge base. Since no single available method, for example interviewing domain experts, is sufficient for removing this bottleneck, we have chosen a combination of different methods. The different backgrounds of knowledge engineers and domain experts could cause communication restrictions and difficulties between them, e.g. they might not understand each others knowledge domain and this will affect formulation of the knowledge. To solve this problem we needed a tool which supports both the knowledge engineer and the domain expert already from the initial phase of developing the knowledge base. We have developed a knowledge acquisition system called KAVE to elicit knowledge from domain experts and storing it in the knowledge base. KAVE is based on a domain specific conceptual model which is a result of cooperation between knowledge engineers and domain experts during identification, design and structuring of knowledge for this domain. KAVE includes a patient simulator to help validate knowledge in the knowledge base and a knowledge editor to facilitate refinement and maintenance of the knowledge base.
The right to clean air in public places (RCA) is a useful indicator of health consciousness. We surveyed the life style and consciousness towards RCA among employees working at the head office of a major company in Osaka, and examined the relationship between life style and knowledge aspect of RCA, one of the three aspects of consciousness towards RCA. Knowledge on laws concerning smoking regulations in public places was classified into two categories. One was knowledge on laws concerning general matters and the other was knowledge on laws concerning concrete and specific matters. Therefore, there are two kinds of relationship; the relationship between life style and knowledge on laws concerning general matters and the relationship between life style and knowledge on laws concerning concrete matters. These two relationships were examined with statistical procedures. Mean scores of knowledge on laws of subgroups divided by HPI score (POOR, MODERATE and GOOD) within groups divided by age and sex ("M. smoker," "M. nonsmoker" and "F. nonsmoker") were compared by t-test. Life style related to knowledge score was checked by correlation coefficient. The following results were obtained. (1) Relationship between life style and knowledge on laws concerning general matters Knowledge scores and their age-adjusted scores of MODERATE groups were the lowest among the 3 groups ("M. smoker," "M. nonsmoker," "F. nonsmoker"). This set of questions was designed to measure the knowledge level on laws concerning general matters. One would have abundant knowledge if one is health-conscious. In other words, those who do many things beneficial to physical health and have a high HPI have a wealth of knowledge on laws concerning smoking regulations on general matters. In the case of the employees, MODERATE groups were less health-oriented than others ("POOR," "GOOD") within the 3 groups ("M. smoker," "M. nonsmoker," "F. nonsmoker"). (2) Relationship between life style and knowledge on laws concerning concrete matters This set of questions was designed to measure the knowledge on laws concerning concrete and specific matters. To attain high scores, it is necessary to have more smoking experiences in various types of indoor places. POOR group of "M. smoker" and MODERATE groups of "M. nonsmoker" and "F. nonsmoker" had high knowledge scores. They were considered to have greater opportunities to visit public places where smoking is permitted (for example, bars) irrespective of their smoking status.
The article describes how Finnish adults understand health. The data were collected by means of free-form thematic interviews and analyzed on the basis of an interpretive approach, representing the phenomenological research tradition. From the interviewees' responses, there emerged two different types of experiential health knowledge, namely institutional and individual health knowledge. Institutional health knowledge found expression in the following themes: knowledge about health as normalcy, knowledge about proper health care, knowledge about factors that may cause illness, knowledge about diseases observed in oneself, and knowledge about obtaining help. Individual health knowledge found expression in the following themes: knowledge about being healthy and feeling well, knowledge about how to produce well-being and how to deal with not feeling well, and knowledge about being ill and not feeling well. The results of the study provide conceptual tools for the further analysis of health knowledge from the perspective of people themselves and at the same time deeper knowledge about the ways in which people perceive health and in which they seek to maintain good health.
Many workers in medical informatics are seeking to reuse knowledge in new applications and to share encoded knowledge across software environments. Knowledge reuse involves many dimensions, including the reapplication of lexicons, ontologies, inference syntax, tasks, and problem-solving methods. Principal obstacles to all current work in knowledge sharing involve the difficulties of achieving consensus regarding what knowledge representations mean, of enumerating the context features and background knowledge required to ascribe meaning to a particular knowledge representation, and of describing knowledge independent of specific interpreters or inference engines. Progress in the area of knowledge sharing will necessitate more practical experience with attempts to interchange knowledge as well as better tools for viewing and editing knowledge representations at appropriate levels of abstraction. The PROTEGE-II project is one attempt to provide a knowledge-base authoring environment in which developers can experiment with the reuse of knowledge-level problem-solving methods, task models, and domain ontologies.
A patient (N.B.) is described, who displays distinct deficits of object knowledge related to knowledge type (Functional/Associative vs Visual) and also to knowledge category (Animate vs Inanimate). The patient was first given an orally presented forced-choice test devised to assess orthogonal combinations of knowledge type and knowledge category. In the production of this test it was found that normals took longer to respond to Visual questions than to Functional/Associative questions; therefore, sets of questions were compiled that were matched for both accuracy and latency. There were two main findings concerning N.B.'s semantic memory. First, with careful matching of difficulty level, the patient showed selective preservation of Functional/Associative knowledge of Animate objects compared with Visual knowledge of Animate objects and also compared with Functional/Associative knowledge of Inanimate objects. Second, there was a qualitative difference in patterns of knowledge retrieval for Visual compared with Functional/Associative knowledge. Retrieval of Visual knowledge, both Animate and Inanimate, was inconsistent and, in a word-pair recall test, a high degree of connection of a Visual property to an object did not promote paired-associate learning. In contrast, retrieval of Functional/Associative knowledge (both Animate and Inanimate) was consistent and paired-associate learning was influenced by connection strength. This study provides strong evidence to support the validity of both "knowledge type" and "category" based accounts of the organisation of semantic memory.
We investigated health and diet knowledge as it relates to coronary heart disease (CHD) in three rural areas which participated in a community-oriented CHD risk factor intervention study. Knowledge of risk factors (risk knowledge) was fairly satisfactory at baseline, but diet knowledge was poor. Males, the young, and individuals with a lower level of education had less knowledge. Intervention consisted of a 3-year small mass media programme in one community (low-intensity intervention, LII), additional interpersonal intervention to high-risk individuals in the second (high-intensity intervention, HII), and no intervention in the control community (C). In the cohorts, with the baseline survey and the follow-up study 4 years apart, knowledge improved by 8.1% points in males (7.5% in females) in the HII community and by 7.1% (6.5%) in the LII community, compared to 5.5% (4.8%) in the C community (P less than 0.01). Diet knowledge improved more than risk knowledge, and individuals with lower initial scores benefitted most. Female scored highest. Educational level made a modest positive contribution to knowledge gain, after adjusting for differences in baseline knowledge. High-risk individuals did not have better knowledge at baseline, nor did they gain more from the intervention. We conclude that community intervention over a 4 year period, based on community diagnosis and tailored to the community's needs, can improve health knowledge.
In this article, I have presented a brief history of research directed toward examining the developing ability of children to comprehend and produce metaphor that occurs with increasing age. I argued that the child's ability in this area does not rest upon developing an ability specific to metaphor, but, instead, metaphor comprehension and production, not unlike other forms of cognition, rests upon a developing theory of the world founded upon an expanding knowledge base. Given that knowledge is central to the child's cognitive development, I turned to an examination of the nature of knowledge. The discussion of knowledge drawn from philosophers who have attempted to propose theories of knowledge in answer to the question, "What is knowledge?" Traditional justificationalist theories of knowledge and subsequently developed nonjustificationalist theories were considered. The discussion was focused upon a number of issues which have divided philosophers with respect to their treatment of knowledge in order to highlight the problematic nature of knowledge. Cognitive and developmental psychologists may wish to consider some of these issues and the implications they hold for their theories as they study knowledge and/or invoke knowledge as a part of their theory construction. Some of the implications of the issues were illustrated in a discussion of the relation of knowledge to the developing child's comprehension and production of metaphor.
Efforts to represent knowledge effectively have been central to progress in various aspects of medical informatics. These efforts range from relatively simple "electronic textbooks" to fairly sophisticated knowledge-based systems, which function as well as, or even better than, human experts faced with similar problems. Knowledge bases have been developed in many fields, but the relatively limited domains and structured language of medicine, as well as the importance of information in the provision of good medical care, have made research in medical knowledge representation an area of intense activity. This paper reviews representative knowledge bases and knowledge-based systems in medicine: electronic textbooks such as PDQ and the Hepatitis Knowledge Base (HKB), rule-based systems such as MYCIN, causal models (e.g., CASNET), and hypothesis- or frame-based systems, exemplified by PIP and INTERNIST-1. The paper describes the relationships among divergent approaches and provides a sense of current and future trends. It examines problems in knowledge-based systems, particularly in knowledge representation and acquisition, and the responses to these challenges. The latter include the use of domain-independent software shells for constructing knowledge bases, the adaptation and use of previously existing knowledge bases, and multiple uses of the same knowledge base for different purposes.
A tool is introduced for the acquisition of pathology knowledge in a formalized form, directly by the expert. Formalization of the knowledge is intended to make descriptive pathology knowledge more suitable for computerized diagnostic support since a formal representation of knowledge allows more extensive indexing, hence more flexible access. The knowledge acquisition (KA) tool also provides a useful research instrument to investigate to what extent pathology knowledge can be made explicit, to what degree ambiguity is present, in what way experts differ when formalizing knowledge, and whether it is feasible to incrementally acquire decision criteria on the basis of the formalized descriptive knowledge. Crucial in the design of the KA tool is the incorporated meta-knowledge, which is reflected by the knowledge-base structure and is used to elicit knowledge from the expert. Knowledge is acquired from the expert via a menu-driven user interface, which follows the general steps of the pathologist when describing a case. The paper discusses the considerations underlying the design, the implementation of the KA tool, and the research goals.
A medical student's fund of knowledge can be assessed by either his demonstrated fund of knowledge on a clinical service or an examination at the completion of the clerkship. During the past 2 years we have evaluated each student's fund of knowledge in two ways: clinical assessment by faculty and residents and performance on the National Board of Medical Examiners Part II Special Surgical Examination given at the end of the surgical clerkship. This study compares the clinical assessment of surgical knowledge for all 100 members of the class of 1984 at the University of Utah with other subjective evaluations such as attitudes and college grade point average and objective measures of performance such as premed MCAT score, Part I National Boards score, and the National Boards Special Surgical Examination. The correlation between clinical assessment of knowledge and the Surgical Examination was 0.23, with a range on individual services from -0.42 to 0.45. There was a higher correlation for the total group of 0.56 between fund of knowledge and attitudes, with a range on individual services of -0.04 to 0.72. The correlations between clinical assessment of knowledge and Part I National Boards, college grade point average, and chemistry MCAT score were 0.23, 0.09, and 0.15, respectively. These results indicate that the clinical assessment of fund of knowledge is not a good predictor of performance on the surgical section of the National Boards. Clinical assessment of fund of knowledge appears to be linked more closely to faculty and resident assessment of student attitudes. There are a couple possible explanations for these results: clinicians are measuring different aspects of knowledge than are National Boards or clinicians do not accurately assess knowledge and confuse attitudes such as interest and enthusiasm with fund of knowledge.
This study aims to examine developmental knowledge related to misconception about weight. Subjects from 5th to 7th graders were asked to reason about justifiable phenomena which never occur in science. After that, before judging weight addition tasks, subjects engaged in some knowledge-generating-tasks to examine which knowledge-generating-tasks relate to misconception. The main results were as follows: (1) Most subjects did not realize untruth about justifiable phenomena, (2) the knowledge which related to misconception were muscular-kinetic-feeling and balance-feeling about weight, and (3) awareness to knowledge-generating-tasks changed with age; 5th graders found the relation about every kind of knowledge-task on chance level responding and 6th and 7th graders found the relation with some justifiable knowledge. Additionally, some 7th graders were not deluded by any knowledge-generating-tasks. These results suggested misconception about weight might relate to inference from some kinds of everyday-knowledge without realizing the inconsistency with science to them. The developmental change of awareness to knowledge-generating-tasks were discussed in terms of coordination subjects' own theory and their use of knowledge.
This article describes the Adult and Child Behavior Knowledge Scales that were used as part of the San Diego Family Health Project to measure knowledge of health behaviors related to cardiovascular diseases in two ethnic groups: Anglo- and Mexican-Americans. The psychometric characteristics of these scales indicate acceptable reliabilities for assessing knowledge of dietary sodium, dietary fat, and exercise among both adults and children and differ from other health knowledge scales in that they focus on "behavioral capability" rather than on the link between behavior and disease. It is believed that the type of information measured by our scales is more closely related to behavior changes sought in contemporary cardiovascular disease prevention trials. Results of ANOVA used to test differences in knowledge by ethnicity and sex indicate strong main effects for ethnicity among both children and adults. However, sex was not consistently related to knowledge, except for the general tendency of males to be more knowledgeable about exercise. Step-wise and simultaneous-entry multiple regression were used to test a subset of variables, including sex, education, self-efficacy, acculturation (for Mexican-Americans), and parental health knowledge (for children) as determinants of health knowledge. Education was the strongest predictor for Anglo-American adults, and acculturation level was the strongest for Mexican-American adults. Among children, the only statistically significant variable was parental acculturation level for Mexican-Americans. The scales were found to be useful in measuring differences in knowledge across cultural/linguistic groups and to clearly identify marginally acculturated Mexican-Americans as being least aware of health-behavior knowledge. Implications are discussed.
Knowledge of the risk precursors to cardiovascular disease is thought to be a key component of health decision making. Many intervention programs have been aimed at increasing the nation's general knowledge of risk factors for cardiovascular disease, although the determinants of the level of cardiovascular disease knowledge are not thoroughly understood. We examined cardiovascular knowledge in a nationally representative sample of the United States population with data from the 1985 Health Promotion and Disease Prevention supplement of the National Health Interview Survey. Interviews with 12,551 white women, 770 Hispanic women, 2,547 black women, 9,832 white men, 576 Hispanic men, and 1,440 black men were used in this analysis. We constructed a seven-item index for cardiovascular disease knowledge. After adjustment for age and education, white men and women scored higher on the cardiovascular disease knowledge index than either their Hispanic or black counterparts. We also examined the relationships of age, education, income, marital status, access to medical care, geographic region, and seven self-reported cardiovascular disease risk factors to the levels of cardiovascular disease knowledge. Education was the strongest predictor of cardiovascular disease knowledge. The variables examined accounted for a small portion of the variance in knowledge. Levels of cardiovascular disease knowledge were lower among respondents with less education and income, those who were not married, those with less access to medical care, and those who were smokers or physically inactive. Therefore, efforts to improve levels of cardiovascular disease knowledge should be directed toward subgroups.
This study is an extension of an earlier investigation of undergraduate students' acquisition of key pedagogical concepts in a physical education teaching methodology course. In that study, Pathfinder, a method for eliciting associative memory networks, was used to describe and compare the pedagogical knowledge structures of students to that of the course instructor. After the course, students' pedagogical knowledge structures corresponded more closely with that of the instructor, and students who corresponded the closest performed better in the course. The results raised an interesting issue regarding the acquisition of knowledge in undergraduate students. Did students acquire a generalizable body of pedagogical knowledge applicable beyond the context of the teaching methodology course or a highly contextualized reflection of their course instructor's knowledge base? In the present study the external validity of the pedagogical knowledge base was examined by using Pathfinder to compare the knowledge structures of students from the initial investigation with knowledge structures of five experienced teacher educators from five different teacher education programs. The findings indicated that students' knowledge structures became significantly more correspondent with that of the experienced teachers' structures from the beginning to the end of the course. Also, students' correspondence with teacher educators' structures following instruction was found to be significantly correlated with academic and teaching performance. The findings point to the external validity of the domain of knowledge under study and the robustness of Pathfinder for capturing pedagogical knowledge.
In this paper it is argued that an expert system requires more than factual knowledge before it can display expertise in a given domain. The additional knowledge consists of the heuristics or 'rules of thumb' used by an expert to manipulate and interpret the factual knowledge. The knowledge acquisition phase of an expert system project involves determining the factual knowledge (which may be obtained from published sources) and the heuristics used by an expert to manipulate that knowledge--these heuristics can only be obtained from an expert. In reviewing existing biological expert systems it is apparent that many contain only the factual knowledge relating to the domain, and lack the heuristics that enable such systems to show expertise. This paper reviews a number of knowledge acquisition techniques which could be used for acquiring heuristic knowledge and discusses when their use is appropriate. The knowledge acquisition techniques discussed are those suitable for the development of small-scale expert systems as these are most likely to be of interest to biologists. The techniques include the use of questionnaires, interview techniques and protocol analysis; particular emphasis is placed on a modification to the 'twenty questions' interview technique which was developed specifically to elicit taxonomic knowledge relating to water mite identification.