THERAPY-PLANNING STRATEGIES FOR CONSULTATION BY COMPUTER

治疗计划是发展的重要领域， 基于计算机的临床咨询系统。 即使在困难的 虽然诊断已经做出，但最佳治疗可能远未明确。 这 当治疗后需要调整时， 观察患者对初始干预的反应。 我们建议基本 研究的代表性和使用的治疗规划策略， 专家临床医生在监测和调整时常规使用的类型 治疗患有严重疾病的患者。 另外我们 建议在一个环境中实施和测试这些新技术， 现有的咨询系统称为ONCOCIN。 ONCOCIN计划是一个 肿瘤学协议管理系统，编码的知识，高度 结构化的癌症化疗方案，并提供治疗建议。 尽管ONCOCIN目前在美国被肿瘤学家常规实验使用， 在斯坦福大学肿瘤学诊所，该计划的能力有限， 管理对治疗有意外反应的患者。 广义 可应用于ONCOCIN的治疗计划方法将拓宽 系统的范围，并增加其临床效用。 总之，这 建议将基础研究与临床表现相结合 知识与有用的应用 研究的具体目标 （1）进行基础研究，以了解可能的代表性， 治疗计划过程，特别是如何修改计划， 治疗周期前或治疗周期中的异常情况;（2）发展为 计算机程序来表示专家的治疗计划过程 临床医生;（3）将计划程序与ONCOCIN连接。

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.