EXPLANATION IN THE CLINICAL SETTING

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Our long-term goal is to improve the overall effectiveness of physicians' time, and thus improve the quality of health care, by improving the information exchange between physicians and patients in clinical settings. Successful treatment of many diseases requires not only effective tools for diagnosis and therapy but also tools or skills that ensure that both physicians' and patients' information needs are met. We propose to design, implement, and test an interactive information system for physicians and adult migraine patients that is designed to save physicians' time in two ways: (a) collecting data from patients and summarizing patient status before each visit, and (b) explaining physicians' instructions to and answering questions by patients. The system will have a knowledge base that covers the physiological mechanisms for migraines, the common therapies, and the most common effects and side effects of those therapies. The computer system will consist of two main programs: (a) an interactive front-end that collects information from patients prior to each visit and summarizes the patient status for the physician, and (b) an intelligent interface, which will deliver explanations in everyday language to patients, and respond intelligently to follow-up questions. We propose to evaluate the effects of such a system by making it available to patients in two different clinics, measuring the clinical outcomes of its use along a number of different variables. Finally, we propose to base the design of our system on empirical studies of explanations actually given in the clinic.