Dealing with medical knowledge: Computers in clinical decision making: T. Deutch, E. Carson and E....
2
T. Deutch. E. Carson and E. Ludwig, Ddiq !t,ith Medical Knou*le&e: Comptrr..s h Clinird Decisim Making (Plenum Press. NeN York. 1994), 298 pages. hardcover. S69.50. ISBN 0-306-44849-l. There are several. now classic books on the application of artificial-intelligence techniques to the field of medicine that probably every reader of this journal has available on the book shelves. Typically. these books comprise descriptions of medical artificial intelligence programs (e.g. [3.4]). often based on edited papers originally published elsewhere (e.g. [I .?I). These books describe research carried out more than a decade ago. Although these books are still extremely valuable. unfortunately no textbook is available attempting to integrate the lessons learned tl-om the now more than 20 years of research in medical decision-making. artificial intelligence included. The only exceptions are more general textbooks on expert systems or artificial intelligence, but in these books medicine is only used as an example tield, not as the primary focus. In many respects, the book reviewed here differs from the books mentioned above: it provides a general. systematic and rcccnt account of medical decision-making from a medical perspective. without restricting to particular systems or techniques The book also differs from other books by adopting control theory as 21paradir_m for describing biological systems as well as the essence of the medical decision-making process. The former is not unusual in medicine, although the application of control theory to human biology has not been as successful as hoped for by researchers: the latter is more controver- sial because decision theory offers J more commonly adopted liamelvork to describe medical decision-making, Examples of issues discussed in the book are: the problems that are of central concern io clinical medicine and how they are solved. what kind of assistance may be useful for clinicians. the sort of medical data and knowledge that is required in medical decision-making. Thus, the book contains discussions about clinical prob- lem-solving. the representation of medical knowledge and methods for medical decision-making. Medical diagnosis and planning of drug therapy are addressed in more detail. The authors have deliberately chosen to pay little attention to the mathematical and computer-science details underlying techniques. However. most common tech- niques used for building medical decision-support systems are covered in the book. and related to issues such as medical records and the characterization of diagnostic tests in terms of parameters such as sensitivity and specificity. The strongest point of the booh is that it describes computer-based decision-making primarily from a medical perspective. thus offering a unified view of the field. The broadness of the book. however, implies that eken about subjects as medical diagnosis much more cm be skid than addressed in this book. A critical appraisal of the techniques with respect to their medical applicability, certainly a complicated subject, is also missing. Hence. for a full course on medical decision-support or expert systems, the book must be supplemented by special&d books on technical aspects of these systems. The books mentioned above also remain important in this respect.
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Transcript of Dealing with medical knowledge: Computers in clinical decision making: T. Deutch, E. Carson and E....
T. Deutch. E. Carson and E. Ludwig, Ddiq !t,ith Medical Knou*le&e: Comptrr..s h Clinird Decisim Making (Plenum Press. NeN York. 1994), 298 pages. hardcover.
S69.50. ISBN 0-306-44849-l.
There are several. now classic books on the application of artificial-intelligence
techniques to the field of medicine that probably every reader of this journal has
available on the book shelves. Typically. these books comprise descriptions of
medical artificial intelligence programs (e.g. [3.4]). often based on edited papers
originally published elsewhere (e.g. [I .?I). These books describe research carried out
more than a decade ago. Although these books are still extremely valuable.
unfortunately no textbook is available attempting to integrate the lessons learned
tl-om the now more than 20 years of research in medical decision-making. artificial
intelligence included. The only exceptions are more general textbooks on expert
systems or artificial intelligence, but in these books medicine is only used as an
example tield, not as the primary focus. In many respects, the book reviewed here
differs from the books mentioned above: it provides a general. systematic and
rcccnt account of medical decision-making from a medical perspective. without
restricting to particular systems or techniques The book also differs from other
books by adopting control theory as 21 paradir_m for describing biological systems
as well as the essence of the medical decision-making process. The former is not
unusual in medicine, although the application of control theory to human biology
has not been as successful as hoped for by researchers: the latter is more controver-
sial because decision theory offers J more commonly adopted liamelvork to
describe medical decision-making,
Examples of issues discussed in the book are: the problems that are of central
concern io clinical medicine and how they are solved. what kind of assistance may
be useful for clinicians. the sort of medical data and knowledge that is required in
medical decision-making. Thus, the book contains discussions about clinical prob-
lem-solving. the representation of medical knowledge and methods for medical
decision-making. Medical diagnosis and planning of drug therapy are addressed in
more detail.
The authors have deliberately chosen to pay little attention to the mathematical
and computer-science details underlying techniques. However. most common tech-
niques used for building medical decision-support systems are covered in the book.
and related to issues such as medical records and the characterization of diagnostic
tests in terms of parameters such as sensitivity and specificity. The strongest point
of the booh is that it describes computer-based decision-making primarily from a medical perspective. thus offering a unified view of the field. The broadness of the
book. however, implies that eken about subjects as medical diagnosis much more
cm be skid than addressed in this book. A critical appraisal of the techniques with
respect to their medical applicability, certainly a complicated subject, is also
missing. Hence. for a full course on medical decision-support or expert systems, the
book must be supplemented by special&d books on technical aspects of these systems. The books mentioned above also remain important in this respect.
The book will be useful reading for computer scientists interested in the medical field, since it provides them with a good overview of the medical decision-making
process, while at the same time showing where in this process the techniques with which they are familiar fit in. People with a medical background will appreciate the
book for its non-technical overview of computer-based medical decision-making.
PETER LUCAS
Department of Computer Sciencr C’trwht University
P.O. Box 80.089
X08 TB Ufrecht The, ,Yetherlunds
E-mail: lu~us(~~~.~.ruu.nI: fiis: + 3 I 30 2513791
References
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[31 [41
B.G. Buchanan and E.H. Shortliffe, Rule-based E.yerr Systrms: the MYCIN Experimrr~ts of thr Stu~J~rd Heuristic, Programming Prqjec,t (Addison-Wesley, Reading, 1984).
W.J. Clancey and E.H. Shortliffe. eds.. Readings in Medicul Art$ic,itrl Intelligence: the First Drcude (Addison-Wesley, Reading, 1984).
L. Johnson and E.T. Keravnou. E.xpert .System~ Architecturrs (Kogan Page, London. 1988).
P. Szolovits, ed., Art$icial Zntrlligencr in Medicine (Westview Press, Boulder, CO, 1982).
