PMCCPMCCPMCC

Search tips
Search criteria 

Advanced

 
Logo of jamiaAlertsAuthor InstructionsSubmitAboutJAMIA - The Journal of the American Medical Informatics Association
 
J Am Med Inform Assoc. 1995 Sep-Oct; 2(5): 297–306.
PMCID: PMC116270

Evaluation of long-term maintenance of a large medical knowledge base.

Abstract

OBJECTIVE: Evaluate the effects of long-term maintenance activities on existing portions of a large internal medicine knowledge base. DESIGN: Five physicians who were not among the original developers of the knowledge base independently updated a total of 15 QMR disease profiles; each updated submission was modified by a review of group serving as the "gold standard, " and the pre- and post-study versions of each updated disease profile were compared. MEASUREMENTS: Numbers and types of changes, defined as any difference between the original version and the final version of a disease profile; reason for each change; and bibliographic references cited by the physicians as supporting evidence. RESULTS: A total of 16% of all entries were modified by the updating process; up to 95% of the entries in a disease profile were affected. The two most common modifications were changes to the frequency of an entry, and creation of a new entry. Laboratory findings were affected much more often than were history, symptom, or physical exam findings. The dominant reason for changes was appearance of new evidence in the medical literature. The literature cited ranged from 1944 to the present. CONCLUSIONS: This study provides an evaluation of the rate of change within the QMR medical knowledge base due to long-term maintenance. The results show that this is a demanding activity that may profoundly affect certain portions of a knowledge base, and that different types of knowledge (e.g., simple laboratory vs expensive or invasive laboratory findings) are affected by the process in different ways.

Full Text

The Full Text of this article is available as a PDF (1.0M).

Selected References

These references are in PubMed. This may not be the complete list of references from this article.
  • Widmer G, Horn W, Nagele B. Automatic knowledge base refinement: learning from examples and deep knowledge in rheumatology. Artif Intell Med. 1993 Jun;5(3):225–243. [PubMed]
  • Compton P, Jansen R. Diabetes expert systems: planning for long term use. Horm Metab Res Suppl. 1990;24:124–129. [PubMed]
  • Miller RA, Pople HE, Jr, Myers JD. Internist-1, an experimental computer-based diagnostic consultant for general internal medicine. N Engl J Med. 1982 Aug 19;307(8):468–476. [PubMed]
  • Miller RA, Masarie FE., Jr The demise of the "Greek Oracle" model for medical diagnostic systems. Methods Inf Med. 1990 Jan;29(1):1–2. [PubMed]
  • Giuse NB, Giuse DA, Miller RA, Bankowitz RA, Janosky JE, Davidoff F, Hillner BE, Hripcsak G, Lincoln MJ, Middleton B, et al. Evaluating consensus among physicians in medical knowledge base construction. Methods Inf Med. 1993 Apr;32(2):137–145. [PubMed]
  • Giuse DA, Giuse NB, Miller RA. Consistency enforcement in medical knowledge base construction. Artif Intell Med. 1993 Jun;5(3):245–252. [PubMed]
  • Masarie FE, Jr, Miller RA, Myers JD. INTERNIST-I properties: representing common sense and good medical practice in a computerized medical knowledge base. Comput Biomed Res. 1985 Oct;18(5):458–479. [PubMed]
  • Giuse DA, Giuse NB, Bankowitz RA, Miller RA. Heuristic determination of quantitative data for knowledge acquisition in medicine. Comput Biomed Res. 1991 Jun;24(3):261–272. [PubMed]
  • Miller RA. Medical diagnostic decision support systems--past, present, and future: a threaded bibliography and brief commentary. J Am Med Inform Assoc. 1994 Jan-Feb;1(1):8–27. [PMC free article] [PubMed]
  • Giuse NB, Huber JT, Giuse DA, Brown CW, Jr, Bankowitz RA, Hunt S. Information needs of health care professionals in an AIDS outpatient clinic as determined by chart review. J Am Med Inform Assoc. 1994 Sep-Oct;1(5):395–403. [PMC free article] [PubMed]
  • Puppe B, Puppe F. A knowledge representation concept facilitating construction and maintenance of large knowledge bases. Methods Inf Med. 1988 Feb;27(1):10–16. [PubMed]

Articles from Journal of the American Medical Informatics Association : JAMIA are provided here courtesy of American Medical Informatics Association