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Biomedical subjects

L M Bernstein

Publications and source records attributed to L M Bernstein.

10 recordsLinked to original sources
PubMed1980

The hepatitis knowledge base. A prototype information transfer system.

The Hepatitis Knowledge Base is a prototype computerized information-transfer system aimed at supporting the health practitioner's day-to-day diagnosis, prognosis, and treatment decisions concerned with viral hepatitis. An overview of information-transfer problems in biomedicine is presented and issues pertinent to the knowledge-base concept are discussed. The following research activities are described: selection and organization of the content of the initial draft of the complete Hepatitis Knowledge Base; the method for consensus development by a nationally distributed panel of collaborating experts on the subject matter; methods for updating the knowledge base and maintaining its currency over time; use of a computer conferencing network as the principal medium of communication among the geographically dispersed experts and the project staff; support of on-line access to the knowledge-base contents; and formative evaluation of the above methods and limited field testing of the access system.

Hepatitis, Viral, Human↗
PubMed1978

Computer use in diagnosis, prognosis, and therapy.

Computers are used to influence diagnostic and therapeutic decisions. The computer's information-handling capabilities allow it to serve as a reliable extension of the physician's memory and expander of the physician's information and synthesized knowledge resources. Computers have been used to facilitate decisions through organization of patient data, improved classification of patients, decision analysis in clinical settings, and simulation of expert clinical reasoning. Computer programs are more successful in narrow, constrained, single arenas of medicine with much underlying pathophysiologic understanding and where decisions are based largely on hard laboratory data. New models of synthetic reasoning that simulate expert clinical behavior show promise of supporting complicated decisions concerning problems of multiple diseases. All systems are confronted by problems of consensus and authority of the underlying information used.

Computers↗
PubMedDate not supplied

Framing effects in choices between multioutcome life-expectancy lotteries.

AIM: To explore framing or editing effects and a method to debias framing in a clinical context. METHOD: Clinical scenarios using multioutcome life-expectancy lotteries of equal value required choices between two supplementary drugs that either prolonged or shortened life from the 20-year beneficial effect of a baseline drug. The effects of these supplementary drugs were presented in two conditions, using a between-subjects design. In segregated editing (n = 116) the effects were presented separately from the effects of the baseline drug. In integrated editing (n = 100), effects of supplementary and baseline drugs were combined in the lottery presentation. Each subject responded to 30 problems. To explore one method of debiasing, another 100 subjects made choices after viewing both segregated and integrated editings of 20 problems (dual framing). RESULTS: Statistically significant preference reversals between segregated and integrated editing of pure lotteries occurred only when one framing placed outcomes in the gain domain, and the other framing placed them in the loss domain. When both editings resulted in gain-domain outcomes only, there was no framing effect. There was a related relationship of framing-effect shifts from losses to gains in mixed-lottery-choice problems. Responses to the dual framing condition did not consistently coincide with responses to either single framing. In some situations, dual framing eliminated or lessened framing effects. CONCLUSION: The results support two components of prospect theory, coding outcomes as gains or losses from a reference point, and an s-shaped utility function (concave in gain, convex in loss domains). Presenting both alternative editings of a complex situation prior to choice more fully informs the decision maker and may help to reduce framing effects. Given the extent to which preferences shift in response to alternative presentations, it is unclear which choice represents the subject's "true preferences."

Adolescent↗