Causal Understanding of Patient Illness in Medical Diagnosis
Causal Understanding of Patient Illness in Medical Diagnosis
复制标题
医学诊断中对患者疾病因果关系的理解
DOI：
10.1007/978-1-4612-5108-8_16
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发表时间：
1981
影响因子：
4.9
通讯作者：
W. Schwartz
中科院分区：
文献类型：
--
作者：
R. Patil;Peter Szolovits;W. Schwartz
第一代人工智能在医学项目中已经清楚地展示了人工智能技术的有用性，然而，人们也认识到人工智能技术的使用。从我们对临床医生行为的研究中，我们意识到一个诊断或治疗项目必须在不同的细节层面考虑一个病例，将整体理解与细节知识结合起来。我们已经对电解质和酸碱紊乱提供专家咨询的问题进行了研究。我们已经部分完成了ABEL的实施，这是整体工作的诊断部分。本文主要研究ABLL。描述病人的机制。这种描述被称为患者特定模型，包括患者的数据以及程序在多层次因果网络中对这些数据的假设解释。这种描述的最低层次由关于患者的病理生理知识组成，这些知识依次聚合成更高层次的概念和关系。该描述的总体水平总结了患者数据，为有效探索诊断可能性提供了全局视角。病理生理水平描述提供了处理多种病因疾病引起的复杂临床情况的能力，以评估正在探索的诊断可能性的生理有效性。并将大量看似不相关的事实组织成连贯的因果描述。
First generation AI in Medicine programs have clearly demonstrated the usefulness of AI techniques However, il has also been recognized that the use. of notions such as causal relationships, temporal patterns, and aggregate disease categories in these programs has been too weak From our study of clinician's behavior we realized that a diagnostic or therapeutic program must consider a case at various levels of detail to integrate overall understanding with detailed knowledge, To explore these issues, we have undertaken a study of the problem of providing expert consultation for electrolyte and acid-base disturbances We have partly completed an implementation of ABEL, the diagnostic component of the overall effort. In this paper we concentrate on ABLL.s mechanism for describing a patient. Called the patient-specific model, this description includes data about the patient as well as the program's hypothetical interpretations of these data in a multilevel causal network. The lowest level of this description consists of pathophysiological knowledge about the patient, which is successively aggregated into higher level concepts and relations, gradually shifting the content from pathophysiological to syndromic knowledge The aggregate level of this description summarizes the patient data providing a global perspective for efficient exploration of the diagnostic possibilities The pathophysiological level description provides the ability to handle complex clinical situations arising in illnesses with multiple etiologies, to evaluate the physiological validity of diagnostic possibilities being explored, and to organize large amounts of seemingly unrelated facts into coherent causal descriptions.