Lincoln M J, Turner C W, Haug P J, Williamson J W, Jessen S, Cundick R M, Cundick K, Warner H R
Department of Medical Informatics, University of Utah.
Proc Annu Symp Comput Appl Med Care. 1992:174-8.
Medical informatics could facilitate more effective analysis and use of clinical knowledge by means of expert systems. To be most effective, such systems should be constructed in a manner which is consistent with physicians' cognitive processes. Our past five years' work with a system called Iliad indicates that it provides effective medical training and education. The current research extends our previous work by using a wider array of training and test cases. We also evaluated whether training on specific cases could generalize to improved testing performance on related cases, which featured similar complaints and pathophysiologic mechanisms, but different final diagnoses. In their junior internal medicine clerkship, students (n = 100) completed 1300 Iliad training cases covering 48 diagnoses. The findings indicated improved problem solving on the specifically trained cases as well as the generalization cases. We discuss a possible training model for expert systems such as Iliad.
医学信息学可通过专家系统促进临床知识的更有效分析和利用。为达到最佳效果，此类系统应以与医生认知过程一致的方式构建。我们过去五年使用名为伊利亚德（Iliad）的系统开展的工作表明，它能提供有效的医学培训和教育。当前的研究通过使用更广泛的培训和测试案例扩展了我们之前的工作。我们还评估了针对特定案例的培训是否能推广至对相关案例的测试表现提升，这些相关案例具有相似的主诉和病理生理机制，但最终诊断不同。在初级内科实习阶段，100名学生完成了涵盖48种诊断的1300个伊利亚德培训案例。研究结果表明，在经过专门训练的案例以及推广案例中，问题解决能力均有所提高。我们讨论了一种适用于伊利亚德等专家系统的可能培训模式。
