Showing papers on "Clinical decision support system published in 1988"

“Issue-based decision support systems for the Egyptian cabinet

Abstract: This paper provides a new approach for managing the design and delivery of information and decision support systems for strategic decision making. It draws on experiences gained from implementing systems and services for enhancing the strategic decision-making process of the Cabinet of Egypt. The article challenges the conventional views of conceptualizing decision support systems and methods for managing them. It introduces an "issue-based" management method for the design and delivery processes. The distinctive features of this approach include a focus on issues rather than decisions, a distinction between information support services and decision support services, prototyping the management of delivery as well as design, and a dynamic tracking back-end. Finally, the article compares the conventional and issue-based DSS approaches. Such a comparison suggests that the issue-based approach can be an effective stepping stone for the design and delivery of executive information systems (EIS) in corporate contexts by providing DSS that are "EIS-ready."

Expert Systems and Decision Support in Medicine

Abstract: Jan H. van Bemmel Department of Medical Informatics Faculty of Medicine, Erasmus University Rotterdam The Netherlands Different methods for decision support in medicine are reviewed and the reasons for their success and failure are analyzed. Our discussion is guided by the literature on this subject, and primarily by the critical reviews of Professor Peter Reichertz, who was one of the founding fathers of Medical Informatics. Our review starts by analyzing the usefulness of the (computer-based) medical record for decision making and looks at the possibilities of integrating decision support programs with information systems in hospitals. The different types of medical knowledge (empirical and scientific) and their implementations (as statistical, logical, inverse, or heuristic models) are discussed. Suggestions are made for future research in decision support in medicine, and the consequences for the medical curriculum are mentioned. The paper contains frequent citations from the publications from Peter Reichertz, to whose memory this review is dedicated.

Economic aspects of clinical decision making: applications of clinical decision analysis

Abstract: Clinical decision analysis as a basic tool for decision making is described, and potential applications of decision analysis in six areas of clinical practice are identified. Clinical decision analysis is a systematic method of describing clinical problems in a quantitative fashion, identifying possible courses of action, assessing the probability and value of outcomes, and then making a calculation to select the ultimate course of action. Clinical decision analysis provides a structure for clinical decision problems, helps clarify medical controversies, and encourages decision makers to speak a common language. Applications of clinical decision analysis in the areas of diagnostic testing, patient management, product and program selection, research and education, patient preferences, and health-care-policy evaluation are described. Decision analysis offers health professionals a tool for making quantifiable, cost-effective clinical decisions, especially in terms of clinical outcomes.

Improving the effectiveness of strategic decision making using an integrated decision support system

Abstract: Decision support systems (DSSs) are used in many types of business. However, which type is suitable for a specific purpose? How do expert systems help DSS? This paper analyses the popular DSS packages on the market and offers a general overview about their use now and in the future.

On the Assessment of Medical Expert Systems

Abstract: In this report we examine some paradigms for a comprehensive evaluation of an Expert System in the health field. This methodology is considered here as an intellectual tool to improve the performance of health professionals in tackling defined health problems. In this respect, the known experiences about the assessment of the performance of Medical Expert Systems’ seem rather narrow in their aims. Therefore, different contexts for the evaluation are proposed, in respect to a range of criteria that show growing width and subjectivity. Four levels are described: i) raw efficiency of the system in itself; ii) effectiveness in the user’s environment; iii) long term effects on the user’s behaviour; iv) effectiveness on the health problem. We propose a cooperative effort to drive and support the evaluations: to establish detailed guidelines, to give rise to a collection of reviews about each system and to mantain a register of applications.

Decision Support in Medicine

Abstract: Different methods for decision support in medicine are reviewed and the reasons for their success and failure are analyzed. Our discussion is guided by the literature on this subject, and primarily by the critical reviews of Professor Peter Reichertz, who was one of the founding fathers of Medical Informatics. Our review starts by analyzing the usefulness of the (computer-based) medical record for decision making and looks at the possibilities of integrating decision support programs with information systems in hospitals. The different types of medical knowledge (empirical and scientific) and their implementations (as statistical, logical, inverse, or heuristic models) are discussed. Suggestions are made for future research in decision support in medicine, and the consequences for the medical curriculum are mentioned. The paper contains frequent citations from the publications from Peter Reichertz, to whose memory this review is dedicated.

Diagnostic support in the Oxford System of Medicine

Abstract: The Oxford System of Medicine (OSM) project was started in 1985 with the aim of producing a working specification for a decision support system for general practitioners. The feasibility of such a project seems to depend upon designing a system that is acceptable to general practitioners and acquiring, verifying and maintaining the knowledge base. The authors consider that a knowledge-based theory of decision making, coupled to strategic and policy defining knowledge about diagnosis or any other task, and separated from the simple facts of medicine could be the cornerstone for a decision support system that is flexible enough to provide a suitable environment for author, editor and general practitioner. They present an example of diagnostic consultation starting with the problem of a swelling joint.

Systems for cooperative work and group decision-making: status of use and problems in development

Abstract: The application of computer and information technology to cooperative work and group decision-making has grown out of three traditions: computer-based communications, computer-based information service provision, and computer-based decision support. The authors provide an overview of the various kinds of systems that have been configured to meet the needs of groups at work, evaluates the status of these systems in the US, evaluates the experience with them, assesses barriers to their further development and use, and draws conclusions about what future work in this area should be undertaken. >

Artificial Intelligence in Medicine: An Emerging Discipline

Abstract: Over the past 25 years there have been a wide variety of computer applications in medicine. They include financial and accounting systems, clinical data management systems, biomedical engineering applications, clinical decision support systems, and many more. This book addresses a particular type of medical computer research, the application of artificial intelligence (Al) techniques in medicine.

Perceptions of system effectiveness as viewed by executives, users, and information specialists

Abstract: The authors review the performance of a computer-based marketing information system that was implemented in June 1982. Attention is focused on the reasons why the system was implemented, the process of system design, the impact of the system on corporate strategy and activity, and the system's effectiveness as perceived by the organization's executives, users, and information specialists. The objective is to provide a behind-the-scenes look at a system. The authors conclude with a list of suggestions that readers can consider in maximizing the performance of computer-based management information and decision support systems. >

Mental Health Management Decision Making in the Age of the Computer

Abstract: Both modern computer technology and the current community oriented era of mental health programs developed into important phenomena in the 1950s. The availability of the new technology at the beginning of a period of fundamental reform in mental health raised high hopes for the positive support information technology could contribute to the mental health program reform movement. Over the past thirty years, computer technology has developed and flourished far beyond anyone's greatest expectations. At the same time, while many valuable and interesting mental health computer applications have been produced, the impact of the computer on the overall development and management of mental health services has been limited. Another major wave of reform, this time in terms of funding patterns, is now on the horizon for mental health. It would appear that the impact of computer in the management of future mental health programs could be either very positive or very negative, depending on the management tools and the...

Introduction—Special Focus and Decision Support Systems (DSS)

Abstract: The history of Operations Research has been intertwined with computation and decision making. If we examine the fundamental methodologies that have become associated with operations research, we see that each has resulted from the need to make decisions, and that many of them require considerable numerical computation to obtain results that can support decision makers. Notice the phrasing that is almost ingrained in the way we think of operations research work: support decision making. We do not, as a profession, claim that we are the decision makers but we believe the importance of our work comes from helping, or supporting decision makers, in making the best choice based on the information available.

Artificial intelligence and expert systems. Implications for health care delivery.

Abstract: (1988). Artificial Intelligence and Expert Systems: Implications for Health Care Delivery. Hospital Topics: Vol. 66, No. 5, pp. 16-19.

Medical informatics: clinical decision making and beyond

Abstract: Does Medical Informatics encompass all aspects of computing in health care, or is it limited to information processing in clinical medicine? A panel discussion will present several points of view. This paper advocates a unified view of Medical Informatics. It argues that in the future it will not be possible to separate purely clinical information systems from other aspects of computing in health care, and all health care systems should be a part of Medical Informatics.