Transformation of knowledge into clinical support tools

Question 1

Internist-1 Nickname and Description

And what were the descendant systems?

Answer 1

“Jack in a Box”
Diagnostic Decision Support tool that stored associated findings in each disease with “frequencies” and “evoking strengths” used hypthesis - deductive reasoning

Evolved into QMR, DxPlain, and Iliad (which added Baysian stats)

Question 2

Significance of MYCIN

Answer 2

Shotliff, 1970’s
Used Production Rules:
Knowledge encoded as IF-THEN RULES
USED Backward Chaining to relentlessly ask questions to come to a diagnosis. (Different from Internist/QMR/DXPlain which came up with a differential based on scoring and heuristics)

Question 3

What type of controlled terminology is ICD9?

What are some of the problems?

Answer 3

Enumerative scheme that is finite and fixed. Pre-enumerative of concepts with marginally represented relationships (# sequence) versus composable terminology (snomed)

Problems (hard to ad terms, hard to find terms, definitions informal at best)

Question 4

What are the 4 types of data in computers?

Answer 4

Integers: Age, Heartbeats per minute,
Real Numbers: (a measured variable) pH, Blood pressure (mm HG), EKG (mV)
Codes = Diseases, Drugs
Natural Language: Events, Patient history, Some treatments

Question 5

What is Accuracy versus Precision? What is systematic error?

Answer 5

Accuracy is the degree to which the measure is close to the “true value.” Also, known as the ability to do something without mistakes

Precision is the degree of refinement or granularity.

A measure can be inaccurate but precise: For example, a scale reads 75.125 kg every time. . .but that is far from the true value of 70Kg.