Download PDF
Methods Inf Med 1995; 34(01/02): 202-208
DOI: 10.1055/s-0038-1634575
Original article
Schattauer GmbH

Decision Support Systems from the Standpoint of Knowledge Representation

P. Degoulet
1   Broussais University Hospital, Medical Informatics Department, Paris
,
M. Fieschi
2   La Timone University Hospital, Medical Informatics Department, Marseille, France
,
G. Chatellier
1   Broussais University Hospital, Medical Informatics Department, Paris
› Author Affiliations
Further Information

Publication History

Publication Date:
09 February 2018 (online)

    Permissions and Reprints

Abstract:

Relationships between decision-support systems and knowledge representation are examined from three different points of view: the characteristics of medical decisions that might influence the selection of appropriate knowledge representations, – the extent to which different knowledge representations can support efficient medical decisions and, – the validation of knowledge hypotheses through the practice of decision support systems. A three-level model of knowledge representation is proposed that includes a contextual, a conceptual and a computational level. Taking into consideration the context that leads to the selection of a given representation raises the issue of multiexpertise and multirepresentation modeling. Implementation of decision support systems as sets of cooperative agents and integration in the health information systems are considered.

Keywords:

Decision-Support System - Epistemology - Knowledge Representation - Artificial Intelligence - Medical Decision
 

  • References

  • 1 Woods W A. Important issues in knowledge representation. Proc IEEE 1986; 74: 1322-34.
    CrossrefPubMedGoogle Scholar
  • 2 Miller RA. Medical diagnostic decision support systems. Past, present and future. J Am Med Inform Assoc 1994; 1: 8-27.
    CrossrefPubMedGoogle Scholar
  • 3 Searle JR. Intentionality. An Essay on the Philosophy of Mind. Cambridge: Cambridge University Press; 1983
    Google Scholar
  • 4 Mallach EG. Understanding Decision Support Systems and Expert Systems. Burr Ridge, Illinois: Irwin; 1994
    Google Scholar
  • 5 Shortliffe EH. The adolescence of AI in medicine: will the field corne of age in the ’90s?. AI in Med 1993; 5: 93-106.
    PubMedGoogle Scholar
  • 6 Davis R, Shrobe H, Szolovits P. What is a knowledge representation?. AI Magazine 1993; 14: 17-33.
    PubMedGoogle Scholar
  • 7 McCarthy J, Hayes PJ. Some philosophical problems from the standpoint of artificial intelligence. In: Meltzer B, Michie D. eds. Machine Intelligence. Edinburgh: Edinburgh University Press; 1969. 4 463-502.
    Google Scholar
  • 8 Winograd T, Flores F. Understanding Computers and Cognition – A New Foundation for Design. Norwood, NJ: Ablex Publishing Corporation; 1986
    Google Scholar
  • 9 Nagao M. Knowledge and Inference. Boston: Academic Press; 1990
    Google Scholar
  • 10 Maturana HR. Biology of language: the epistemology of reality. In: Miller GA, Nenneberg E. eds. Psychology and Biology of Language and Thought: Essays in Honor of Eric Nenneberg. New York: Academic Press; 1978: 27-64.
    Google Scholar
  • 11 Degoulet P, Jean FC. The need for pragmatic database models. In: Computerized Nalllral Medical Language Processing for Knowledge Representarion. Amsterdam: Elsevier; 1989: 157-67.
    Google Scholar
  • 12 Levinson SC. Pragmatics. Cambridge: Cambridge University Press; 1983
    Google Scholar
  • 13 Austin JL. How to Do Things with Words. Cambridge, MA: Harvard University Press; 1962
    Google Scholar
  • 14 Searle JR. Speech Acts. An Essay on the Philosophy of Language. Cambridge: Cambridge University Press; 1969
    Google Scholar
  • 15 Cohen PR, Perrault CR. Elements of a planbased theory of speech acts. Cognitive Science 1979; 3: 177-212.
    CrossrefPubMedGoogle Scholar
  • 16 Brachman RJ. On the epistemological status of semantic networks. In: Findler NV. ed. Associative Networks: Representation and Use of Knowledge by Computers. New York: Academic Press; 1979: 3-50.
    Google Scholar
  • 17 Winston PH. Artificial Intelligence. Reading, Massachusetts: Addison-Wesley; 1st edition. 1977. 2d edition 1984; 3rd edition 1992.
    Google Scholar
  • 18 Zadeh LH. Fuzzy logic, neural networks, and soft computing. Comm ACM 1994; 37: 77-84.
    CrossrefPubMedGoogle Scholar
  • 19 Hinton GE. Implementing semantic networks in parallel hardware. In: Hinton GE, Anderson A. eds. Parallel models of associative memory. Hillsdale, NJ: Erlbaum; 1981
    Google Scholar
  • 20 Rumelhart DE, Widrow B, Lehr MA. The basic ideas in neural networks. Comm ACM 1994; 37: 87-92.
    PubMedGoogle Scholar
  • 21 Dreyfus HL. What computer can’t do: a critique of artificial reason. New York: Harper & Row; 1972. (Revised edition 1979).
    Google Scholar
  • 22 Dreyfus HL. From micro-worlds to knowledge representation: AI at an impasse. In: Haugeland J. ed. Mind Design. Cambridge MA: MIT Press; 1981: 161-204.
    Google Scholar
  • 23 Sowa JF. Conceptual Structures. Information processing in mind and machine. Reading, MA: Addison-Wesley; 1984
    Google Scholar
  • 24 Halpern DF. Thought and Knowledge. Hillsdale, New Jersey: Lawrence Erlbaum Associates; 1989
    Google Scholar
  • 25 Pham KM, Degoulet P. MOSAIC: a macroconnectionist expert system generator. Experts Systems with Applications 1991; 2: 29-45.
    CrossrefPubMedGoogle Scholar
  • 26 Lanzola G, Stefanelli M. Inferential knowledge acquisition. Artif Intell Med 1993; 5: 253-68.
    CrossrefPubMedGoogle Scholar
  • 27 Safran CD, Porter D, Lightfoot J. et al. ClinQuery: a system for on-line searching of data in a teaching hospital. Ann Int Med 1989; 111: 751-6.
    CrossrefPubMedGoogle Scholar
  • 28 Jean FC, Lavril M, Lemaitre D, Sauquet S, Degoulet P. A software engineering approach for medical workstation development. Int J Biomed Comput 1994; 34: 249-60.
    CrossrefPubMedGoogle Scholar
  • 29 Greenes RA, Deibel SR. The DeSyGNER knowledge management architecture: a building block approach based on an extensible kernel. Artif Intell Med 1991; 3: 95-111.
    CrossrefPubMedGoogle Scholar
  • 30 Degoulet P, Coignard J, Jean FC. et al. The HELIOS European project on software engineering. In: Timmers T, Blum BI. eds. Software Engineering in Medical Informatics. Amsterdam: Elsevier; 1991: 125-37.
    Google Scholar
  • 31 Arkad K, Ahlfeldt H, Gao X. et al. Integration of data driven decision support into the HELIOS environment. Int J Biomed Comput 1994; 34: 195-205.
    CrossrefPubMedGoogle Scholar
  • 32 Van Mulligen EM, Timmers T, Brand J. et al. HERMES: a health care workstation integration architecture. Int J Biomed Comput 1994; 34: 267-75.
    CrossrefPubMedGoogle Scholar
  • 33 Cimino JJ. Data storage and knowledge representation for clinical workstations. Int J Biomed Comput 1994; 34: 185-94.
    CrossrefPubMedGoogle Scholar
  • 34 Miller PL, Black HR. Medical plan-analysis by computer: critiquing the pharma-208 cologie management of essential hypertension. Comput Biomed Res 1984; 17: 38-54.
    CrossrefPubMedGoogle Scholar
  • 35 Adelman L. Evaluating Decision Supports and Systems. New York: John Wiley & Sons; 1992
    Google Scholar
  • 36 Fieschi M. Towards validation of expert systems as medical decision aids. Int J Biomed Comput 1990; 26: 93-108.
    CrossrefPubMedGoogle Scholar
  • 37 Wyatt J, Spiegelhalter D. Evaluating medical expert systems. Med Inform 1990; 15: 205-17.
    PubMedGoogle Scholar
  • 38 Fox J. On the soundness and safety of expert systems. Artif Intell Med 1993; 5: 1592-7.
    PubMedGoogle Scholar
  • 39 Dawson NV, Arkes HR. Systematic errors in medical decision making: judgrnentallimitations. J Gen Intern Med 1987; 2: 183-7.
    CrossrefPubMedGoogle Scholar