[Prospects of using computer expert system in the diagnosis of diseases of the respiratory system].
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Diagnosis, Computer-Assisted↗
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Results for “Expert Systems”
Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.
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[Expert system for establishing indications for radiation and combined therapy of patients with non-hodgkin's lymphoma].
Mathematical procedures have been employed which enable to carry out automatic selection within small groups of patients with primary non-Hodgkin's disease, with a view to choose between chemoradiation, radiation or drug therapy. The study included 670 patients, aged 15-79, who were followed up for 1-10 years. Groups were formed on the basis of the following prognostically-significant parameters: sex and age, histological pattern and stage, primary localization and maximal size of tumor (involvement of the mediastinum, bone marrow and peripheral blood). Each group was conceived on the basis of two or three parameters. The efficacy of each therapeutical modality was assessed using the data on overall and recurrence-free survival. A computerized program was used for making prognosis for each patient which, in turn, determined the choice of the most effective type of treatment.
Adolescent↗
Applications of expert computer systems.
An expert system is a computer program which uses artificial intelligence to make logical decisions on the basis of input data. The rules the system uses to make its decisions are called heuristics which can be provided in the form of IF . . . THEN statements, or they can be learned by the system from examples. The term "expert" is used because the rules or examples come from human experts and the program is considered to have captured their expertise. Currently there are many expert systems in business and medical use but few, if any, are used in optometry. The rule-oriented nature of many ophthalmic procedures suggests a future role for these systems, but their cost-effectiveness may not yet be favorable enough to justify development of expert systems for optometric practice.
Diagnosis, Computer-Assisted↗
Expert medical consultation systems.
Expert medical consultation systems have come of age in the last 5 years. There has been considerable progress in developing new and powerful representations for medical knowledge, microprocessor- and instrument-related expert systems, methods for knowledge acquisition and learning, and more sophisticated techniques of reasoning, explanation, and evaluation.
Computers↗
EpiMAN-FMD: a decision support system for managing epidemics of vesicular disease.
A comprehensive epidemiological information system (EpiMAN-FMD) has been developed to assist national disease control authorities contain and eradicate outbreaks of animal diseases as efficiently and cost-effectively as possible. The system was initially developed to control an incursion of foot and mouth disease (FMD) or any clinically indistinguishable vesicular disease, although it has since been progressively expanded to manage other exotic and endemic diseases. Design objectives for the information management elements of EpiMAN-FMD included the following: the need to manage the vast quantities of data that eradication procedures for an FMD epidemic would generate within a very short time the ability to innovatively apply epidemiological understanding of disease spread to the data processing tasks the reduction of some of the foreseen processing bottlenecks the provision of decision support tools for data entry personnel. Design objectives for the veterinary management elements of the system included the following: the presentation of up-to-date status reports in formats that facilitate decision-making at the national or regional level the ability to optimise manpower resource allocation the capacity to evaluate the relative merits of alternative technical decisions, each of which carry different implicit risks. The system combines a multi-user database management system, expert system elements, various computer simulation models of specific aspects of FMD epidemiology and a range of statistical analyses designed to monitor the state of the epidemic. Although designed in New Zealand, EpiMAN-FMD has been constructed in a flexible style which makes adoption of the system possible in other countries with broadly similar 'stamping-out' contingency plans.
Animals↗
Computer-assisted localization of nervous system injuries.
Expert systems to assist in neurological diagnosis require a representation of anatomical relationships. In order to test one representational method, a prototype expert system was developed. It accepts patient signs of neurological dysfunction and identifies the site of nervous system injury. The system's knowledge base is contained in a semantic network which represents nervous system anatomy and the physical signs of injuries. When provided with an individual's physical signs, the network is searched by a simple algorithm; the anatomical locations which best explain the physical signs are the system's output. Medical expert systems which require anatomical reasoning can use a direct representation of spatial relationships to avoid the difficulties of encoding clinical associations in the form of If-Then rules.
Algorithms↗
Protocols and guides, tools.
The author describes in the first part of the review the definitions and relations of the occurring concepts. In the second part a short history of the topic is overviewed. The third part is dealing with the electronic patient record based development of guidelines in addition what are the relations among guidelines, protocols, tools, knowledge-based systems, diagnosis supporting systems, expert systems, outcome analysis and artificial intelligence. A short review of what was presented in the MIE '97 in this area is finally described and the Session Chairman's conclusion.
Computer Communication Networks↗
An integrated information system for the intervention and prevention of AIDS.
The epidemic of acquired immune deficiency syndrome (AIDS) and its causative agent, the human immunodeficiency virus (HIV), are serious and spreading. In response to the epidemic, a variety of intervention and prevention programs have been instituted. In such AIDS intervention and prevention (AIP) activities, the role played by information systems becomes more and more important. The applications of information systems technology in AIP mostly seem to fall within a spectrum of databases, decision support systems and expert systems. This paper describes the implementation of an information system in a regional AIDS intervention and prevention program. In this integrative information system, the database is integrated with both decision support systems and expert systems, and decision support systems are integrated with expert systems. The implementation results of the system present evidence of the usefulness of the system in AIDS intervention and prevention.
Acquired Immunodeficiency Syndrome↗
Vertebral morphometry by DXA: a comparison of supine lateral and decubitus lateral densitometers.
Identification of vertebral fracture has become increasingly important in the diagnosis and management of osteoporosis. This study compares the morphometric techniques on a fan beam dual-energy X-ray absorptiometry (DXA) GE-Lunar Expert system (Expert) using a supine lateral position and a narrow fan beam GE-Lunar Prodigy system (Prodigy; GE Lunar, Madison, WI) that requires lateral decubitus positioning. Patient acceptability, image quality, observer, and equipment variability were determined. Study subjects were recruited from clinical referrals sent for a routine DXA study that included vertebral morphometry. Twenty-five patients underwent lateral vertebral assessment on both machines and completed a questionnaire on comfort and tolerability. Analysis was undertaken by two trained observers. Vertebral height, anterior/posterior height (A/P) and mid/posterior height (M/P) ratios, image quality, and prevalent fractures were assessed. There were no significant differences in patient comfort or image quality scores. More upper thoracic vertebrae could be assessed on the Expert, and good radiographic positioning was easier to achieve on the Expert. Inter-observer coefficients of variance percentage (CV%) of vertebral height was lower on the Prodigy (3.5% in the lumbar spine rising to 12.8% in the thoracic spine) than the Expert (4.2% to 16.9%). Inter-observer CV% for A/P and M/P ratios varied from 2.5% to 10.5% on the Prodigy compared with 3.5% to 12.3% on the Expert, depending on vertebral level. The variation between instruments was similar to the inter-observer CV% (anterior height: -0.11+/-1.65 mm; mid height: 0.54+/-1.51 mm; posterior height: 0.43+/-1.46 mm). There was good agreement between observers and between the Expert and Prodigy in identifying severe fractures, but lack of agreement in identifying moderate fractures. In conclusion, there was no clinically significant difference in patient comfort and image quality between the Expert and the Prodigy. The inter-observer variations in vertebral height and A/P and M/P ratios are similar to the variations between instruments. In making the change from the supine lateral to the decubitus lateral positioning, measurements of vertebral height are reproducible and patient comfort is not compromised.
Absorptiometry, Photon↗
Clinical relevance: an issue in biostatistical training of medical students.
Significant trends in teaching biostatistics to medical students include: recognition of the dependence of advancement in the medical sciences upon the quantitative sciences; integration of biostatistics and other disciplines such as epidemiology and community medicine; increased emphasis on clinical relevance through the introduction of such topics as medical decision-making, evaluation of diagnostic test, genetic counselling and evaluating health-science literature; growing emphasis on analytic skills and computer literacy as precipitated by the presence of computer-based patient and medical information systems, expert systems, imaging and signal analysis systems; the emergence of new applications of statistics in health and medicine; and changes in the learning environment, for example emphasis on small-group discussions and problem-solving sessions. The evolution and future directions of biometrical training in medicine as precipitated by these trends, and the response of course directors at the Medical University of South Carolina to the demand for a 'new' curriculum in biostatistics for medical students are described.
Attitude of Health Personnel↗
Intelligent systems for human resources.
An intelligent system contains knowledge about some domain; it has sophisticated decision-making processes and the ability to explain its actions. The most important aspect of an intelligent system is its ability to effectively interact with humans to teach or assist complex information processing. Two intelligent systems are Intelligent Tutoring Systems (ITs) and Expert Systems. The ITSs provide instruction to a student similar to a human tutor. The ITSs capture individual performance and tutor deficiencies. These systems consist of an expert module, which contains the knowledge or material to be taught; the student module, which contains a representation of the knowledge the student knows and does not know about the domain; and the instructional or teaching module, which selects specific knowledge to teach, the instructional strategy, and provides assistance to the student to tutor deficiencies. Expert systems contain an expert's knowledge about some domain and perform specialized tasks or aid a novice in the performance of certain tasks. The most important part of an expert system is the knowledge base. This knowledge base contains all the specialized and technical knowledge an expert possesses. For an expert system to interact effectively with humans, it must have the ability to explain its actions. Use of intelligent systems can have a profound effect on human resources. The ITSs can provide better training by tutoring on an individual basis, and the expert systems can make better use of human resources through job aiding and performing complex tasks. With increasing training requirements and "doing more with less," intelligent systems can have a positive effect on human resources.
Artificial Intelligence↗
Decision support system and medical liability.
Expert systems, which are going to be an essential tool in Medicine, are evolving in terms of sophistication of both knowledge representation and types of reasoning models used. The more efficient they are, the more often they will be used and professional liability will be involved. So after giving a short survey of configuration and working of expert systems, the authors will study the liabilities of people building and the using expert systems regarding some various dysfunctions. Of course the expert systems have to be considered only for human support and they should not possess any authority themselves, therefore the doctors must keep in mind that it is their own responsibility and as such keep their judgment and criticism. However other professionals could be involved, if they have participated in the building of expert systems. The different liabilities and the burden of proof are discussed according to some possible dysfunctions. In any case the final proof is inside the expert system by itself through re-computation of data.
Expert Systems↗
Exploring the optometric application of expert computer systems.
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Computer Systems↗
CADIAG-2 and MYCIN-like systems.
CADIAG-2 and MYCIN-like systems are expert systems with numerous applications in medicine. CADIAG-2 is a fuzzy expert system based on max-min inference, while MYCIN-like systems use combining functions to calculate the global weights (degrees) of suggested diagnoses. This paper brings a comparison of CADIAG-2 and MYCIN-like systems. It studies relations between them and shows how CADIAG-2 can be embedded into MYCIN-like systems. An approach of inclusion of negative knowledge into CADIAG-2 is proposed. Some remarks regarding the acquisition of weights of rules are given as well.
Expert Systems↗
The development of an expert computer system on medical consulation.
In order to master fuzziness and uncertainty in solving human problems, an expert system shell SYSTEM Z-II which can handle both exact and inexact reasoning has been successfully developed. This paper describes how the Z-II system shell works in building a medical consultation expert system which accepts fuzzy human concepts and uncertain factors. This expert system ABVAB in the domain of "Abnormal Vaginal Bleeding" is described to demonstrate the power and flexibility of such system. The methods of approach in the development and testing of this system are presented together with the results.
Diagnosis, Computer-Assisted↗
EDECS: the Emergency Department Expert Charting System.
EDECS, the Emergency Department Expert Charting System, integrates clinical guidelines into the everyday practice of medicine. By generating the medical record and patient aftercare instructions, it facilitates patient care. For this reason, doctors are willing to use it. While using it, the doctors are continually presented with advice regarding documentation, testing, and treatment. Unlike guidelines that attempt to modify behavior through traditional educational methods, these computerized guidelines are seen by the physician every time she sees a patient. We have demonstrated this by directly integrating the guidelines into the process of patient care; we can increase compliance with the guidelines [1]. At present EDECS exists for the chief complaints of occupational exposure to body fluids, acute low back pain, recurrent seizure, fever in children, and males with penile discharge or dysuria. Upon examining the patient, the physician proceeds to the computer, which prompts him for essential information regarding the history and physical examination. Certain items are required for all patients with the chief complaint, others are required based on the answers to these items. Data is analyzed by the computer, which provides advice regarding testing and treatment. Once testing is completed, the system suggests a probable diagnosis and aids in patient disposition and discharge planning. Finally, EDECS prints the medical record as well as patient-specific aftercare instructions. EDECS is a user friendly system; most data is entered via mouse. It is written in the OS-based expert system shell AM(TM) and can be run on an IBM compatible PC or PC network. Rules are generally written in an "if...then" format, but more sophisticated rule structures, including Bayesian models, are used when needed. Each module contains separate subroutines for the history, physical, laboratory ordering, treatment, and disposition. These modules call each other in a dynamic fashion. The system is currently being evaluated for its effect on documentation, appropriateness of use of ancillary tests, appropriateness of use of treatments, physician satisfaction, patient satisfaction, and patient outcomes. Initial results of the system's effect on documentation and use of ancillary tests and treatments show much promise [1]. The Occupational Exposure to Body Fluids module has shown a statistically significant, and sometimes rather dramatic, increase in the level of documentation for nearly all items. Further, the advice given by EDECS has caused an increase in the appropriate use of testing and treatments. For example, unnecessary ancillary tests dropped from 1.5 per patient without the computer to 0.1 per patient with the computer's aid. EDECS facilitates quality management activities and research since it collects standardized information and stores it in an easily retrievable database format. It can also be used to educate medical students and residents about the proper care of patients with a given chief complaint. At this session, EDECS will be demonstrated, and issues regarding the development of guidelines, the encoding of guidelines in rules, and the organizational structure of the software will be presented and discussed.
Child↗
Automated rule-based decision systems in forensic toxicology using expert knowledge: basic principles and practical applications.
This paper presents the basic principles and practical benefits of the application of expert systems (ES) and artificial intelligence (AI) to problem solving in forensic toxicology. We acknowledge the complexity and elegance of the theoretical substance and program algorithms of existing work in these disciplines, while simultaneously observing that many presentations of this material cloak the essential facts and concepts in unnecessary jargon and hyperbole. We attempt to remove the cloak without misrepresenting or oversimplifying the underlying structures. We first present a summary of the history, basic functions, technical fundamentals, and typical applications in three major categories of established ES/AI systems. We then assess the status of ES/AI in the forensic toxicology laboratory (FTL) with emphasis on potential applications. We conclude with an analysis of experiences with ESs in our laboratory where we have used an integrated expert system to reduce laboratory errors, detect internal inconsistencies in data, discover new substance abuse subpopulations, and reduce the frequency of sample reprocessing. We have minimized specimen processing time and instrument wear while maximizing technician efficiency and thus performing more tests for the same or reduced costs.
Artificial Intelligence↗
Automated decision making: the role of expert computer systems in the future of optometry.
BACKGROUND: Artificial intelligence (AI) refers to the ability of a machine, or system, or computer program to make intelligent decisions using the same methods that humans would use. By definition, and expert system (ES) is a computer program that uses knowledge and inference procedures to solve problems which would otherwise require the application of human expertise. METHODS: The role of expert systems in current and future applications in a number of fields were reviewed. RESULTS: Expert systems have and will be making an impact in many fields, including optometry in the future. CONCLUSIONS: Expert systems present an opportunity for the profession of optometry to become more efficient or accurate, provided that their development cost could be justified.
Artificial Intelligence↗