https://repository.upenn.edu/cgi/viewcontent.cgi?article=1146&context=cis_reports

Flexible support for trauma management through goal-directed reasoning and planning

Evaluation of a New Method for Cardiovascular Reasoning

Significant advances have been achieved in the fields of medical informatics and artificial intelligence in medicine in the past three decades and, having demonstrated an ability to support clinical decisions, knowledge-based systems are becoming increasingly ubiquitous in various clinical settings. Nonetheless, few systems have so far been successful in entering routine use. On the one hand, primarily due to methodological difficulties and with very few exceptions, developers have failed to show that pertinent systems are effective in improving patient care. On the other hand, support systems have not been sufficiently well integrated into the routine information processing activity of the clinical users. As a consequence, their clinical utility is disputed and constructive assessmenist further hindered. This thesis describes the development of an intelligent clinical information management support system designed to overcome these obstacles through the adoption of an integrated approach, geared toward the solution of the problems encountered in the acquisition, organisation, review and interpretation of the clinical decision supporting information utilised in the process of monitoring intensive care unit patients with acid-base balance disorders. The system was developed to support this activity incrementally, using the methods of object-oriented analysis, design and implementation, with the active participation of a clinical advisor who assessed the functional and ergonomic compatibility of the system with the supported activity and the integration of a previously validated prototype knowledge-based data interpretation system, which could not evaluated in the clinical setting for the reasons described above.

An intelligent clinical information management support system for the critical care medical environment

The TraumAID system has been designed to provide computerized decision support to optimize the initial definitive management of acutely injured patients after resuscitation and stabilization. The currently deployed system, TraumAID 1.0, addresses penetrating injuries to the abdomen and to the chest. Our experience with TraumAID 1.0 has demonstrated some major deficiencies in rule-based reasoners that are faced with problems of both diagnosis and treatment. To address these deficiencies, we have redesigned the system (TraumAID 2.0), factoring it into two modules: (1) a rule-based reasoner embodying the knowledge and logical machinery needed to link clinical evidence to diagnostic and therapeutic goals, and (2) a planner embodying the global knowledge and logical machinery needed to create a plan that addresses combinations of goals. After describing TraumAID 2.0, we discuss an extension of the TraumAID interface (critique mode interaction) that may improve its acceptability in a clinical setting. We close with a brief discussion of management support in resource-limited environments, which is an important issue in the time-critical context of multiple trauma. Comments University of Pennsylvania Department of Computer and Information Science Technical Report No. MSCIS-90-50. This technical report is available at ScholarlyCommons: http://repository.upenn.edu/cis_reports/579 TraumAID: Reasoning and Planning In The Initial Definitive Management Of Multiple Injuries MS-CIS-90-50 LINC LAB 180 Bonnie L. Webber John R. Clarke Michael Niv Ron Rymon Maria Milagros Ib6iiez Department of Computer and Information Science School of Engineering and Applied Science University of Pennsylvania Philadelphia, PA 191 04

/pdf/traumaid-reasoning-and-planning-in-the-initial-definitive-3om4lmcm1k.pdf

TraumAID: Reasoning and Planning in the Initial Definitive Management of Multiple Injuries

This paper describes the design philosophy underlying an information system for an outpatient specialty department. Flexibility, the ability to adapt the system to a specific hospital situation and to user desired tasks, now and in the future, are the main issues with which the design is dealing. This flexibility is supported in the functional design and in the way communication of data is handled. The use of standards is a key factor in structured data interchange. The system design is independent of any actual standard used. It can incorporate standards that are currently available, and anticipates those that will become available. The open system design is based on data interchange between functional elements within the system, and electronic data interchange with external systems.

Framework for a new generation of medical information systems.

This paper describes the evaluation of a critiquing system, HYPERCRITIC, that relies on automated medical records for its data input. The purpose of HYPERCRITIC is to offer comments to general practitioners on their treatment of hypertension. HYPERCRITIC has access to the data stored in a primary-care information system that supports a fully automated medical record. Medical records of 20 patients with hypertension were submitted to both physicians and HYPERCRITIC. The critique generated by the physicians was subsequently compared to the critique generated by HYPERCRITIC. Of the 260 comments made by the majority of the physicians, 118 were also made by HYPERCRITIC. The reasons why HYPERCRITIC failed to reproduce the remaining 142 comments are evaluated.

Knowledge-Based Systems. Methods for Developing and Evaluating Expert Systems: Critiquing Physician Decision Making Using Data from Automated Medical Records: Assessing the Limitations

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Knowledge-Based Systems. Methods for Developing and Evaluating Expert Systems: Critiquing Physician Decision Making Using Data from Automated Medical Records: Assessing the Limitations