THERAPY-PLANNING STRATEGIES FOR CONSULTATION BY COMPUTER

治疗计划代表着发展的一个重要领域 基于计算机的临床会诊系统。即使是在困难的时候 诊断已经做出，最佳治疗方法可能还远未明朗。这 尤其是在以下情况下需要调整治疗时 观察病人对最初干预措施的反应。我们建议使用基本 心理治疗计划策略的表征与使用研究 专业临床医生在监测和调整时经常使用的类型 治疗有重大疾病实体的患者。此外，我们 建议实施并测试这些新技术在一个 现有的咨询系统被称为ONCOCIN。ONCOCIN计划是一种 肿瘤学协议管理系统，编码高度的知识 结构化癌症化疗方案，并提供治疗建议。 尽管ONCOCIN目前正处于肿瘤学家的常规实验使用中 斯坦福肿瘤学诊所，该计划在能力上受到限制 管理对治疗有意外反应的患者。一种广义的 可应用于ONCOCIN的治疗计划方法将拓宽 扩大了该系统的范围，增加了其临床实用价值。总而言之，这是 建议结合临床表现中的基础研究 知识和有用的应用程序。研究的具体目的 这些措施包括：(1)进行基本研究，研究可能出现的 治疗计划过程，特别是如何修改计划以应对 在治疗周期之前或期间出现异常情况；(2)发展成 表示专家治疗计划过程的计算机程序 临床医生；以及(3)将规划计划与ONCOCIN对接。

Therapy planning represents an important area for the development of computer-based clinical consultation systems. Even when a difficult diagnosis has been made, the optimum treatment may be far from clear. This is particularly true when adjustments to therapy are required after observing a patient's response to initial interventions. We propose basic research into the representation and use of therapy-planning strategies of the type routinely employed by expert clinicians as they monitor and adjust the treatment for patients with serious disease entities. In addition, we propose to implement and test these new techniques in the setting of an existing consultation system known as ONCOCIN. The ONCOCIN program is an oncology protocol management system that encodes the knowledge of highly structured cancer chemotherapy protocols and gives advice on treatment. Although ONCOCIN is currently in routine experimental use by oncologists in the Stanford oncology clinic, the program is limited in its ability to manage patients who have unexpected responses to therapy. A generalized approach to therapy planning that can be applied to ONCOCIN will broaden the system's scope and increase its clinical utility. In summary, this proposal combines basic research in the representation of clinical knowledge with a useful application. The specific aims of the research are: (1) to conduct basic research into possible representations of the therapy planning process, particularly how plans are modified in response to unusual conditions prior to or during treatment cycles; (2) to develop a computer program to represent the therapy planning processes of expert clinicians; and (3) to interface the planning program with ONCOCIN.