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Biomedical subjects

M G Kahn

Publications and source records attributed to M G Kahn.

40 records · Page 3Linked to original sources
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Statistical process control methods for expert system performance monitoring.

The literature on the performance evaluation of medical expert system is extensive, yet most of the techniques used in the early stages of system development are inappropriate for deployed expert systems. Because extensive clinical and informatics expertise and resources are required to perform evaluations, efficient yet effective methods of monitoring performance during the long-term maintenance phase of the expert system life cycle must be devised. Statistical process control techniques provide a well-established methodology that can be used to define policies and procedures for continuous, concurrent performance evaluation. Although the field of statistical process control has been developed for monitoring industrial processes, its tools, techniques, and theory are easily transferred to the evaluation of expert systems. Statistical process tools provide convenient visual methods and heuristic guidelines for detecting meaningful changes in expert system performance. The underlying statistical theory provides estimates of the detection capabilities of alternative evaluation strategies. This paper describes a set of statistical process control tools that can be used to monitor the performance of a number of deployed medical expert systems. It describes how p-charts are used in practice to monitor the GermWatcher expert system. The case volume and error rate of GermWatcher are then used to demonstrate how different inspection strategies would perform.

Evaluation Studies as Topic↗
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Modeling time in medical decision-support programs.

To derive meaningful conclusions in a changing medical setting, medical decision-support systems must represent and reason about the temporal nature of the clinical environments they attempt to model. Because all difficult medical problems have significant temporal features, designers of medical decision support systems must recognize the unique problems caused by representing and reasoning with temporal concepts. This report has three goals: 1) to describe a set of fundamental issues in creating and reasoning with computer models of a changing clinical environment, 2) to present a taxonomy for characterizing the temporal characteristics of computer models of temporal reasoning, and 3) to use this taxonomy to compare the models of time used in some implemented medical decision-support programs. From this examination, it is argued that computational models of time based on a single uniform representational or inferential method are limited by the expressive power of that method. Multiple modeling formalisms that express different temporal properties of the domain task and that work cooperatively are required to capture the subtlety and diversity of temporal features used in expert clinical problem solving. As an example of this approach, the author describes a program called TOPAZ that contains two temporal models that represent different temporal features of the clinical domain.

Classification↗
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The computer-based patient record and Robert Fulghum's 16 principles.

Robert Fulghum proposed 16 principles learned in kindergarten that he claimed should govern all human activities. How do these principles apply to current efforts to create a computer-based patient record? Fulghum's principles, when recast for the computer-based patient record, emphasize cooperation, privacy, security, and standardization--elements that are easily recognized as essential features of an electronic medical record. However, a number of less frequently discussed issues, such as data quality, integrity, abuse, and misuse can also be considered in terms of Fulghum's principles.

Attitude to Computers↗