MEMBER, IEEE, Department of Anesthesiology, Yale University School of Medicine, New Haven, CT 06510.
IEEE Trans Pattern Anal Mach Intell. 1983 May;5(5):449-61. doi: 10.1109/tpami.1983.4767424.
The ATTENDING system is designed to critique a physician's preoperative plan for anesthetic management. In undertaking to critique a physician's plan, ATTENDING differs from other medical decision making systems, which in effect attempt to tell a physician what to do. ATTENDING's approach may prove more acceptable clinically, and may avoid certain social, medical, and medicolegal drawbacks. To cri-tique a physician's plan, ATTENDING must confront three basic problems. 1) It must be able to explore flexibly all possible approaches for a patient's management. The formalism of an ``augmented decision network'' allows this. 2) It must be able to assess the relative risks and benefits of alternative approaches intelligently. A heuristic approach to risk analysis is outlined, based on three basic principles which are de-scribed in detail. 3) It must produce a potentially complex analysis which critiques the plan in focused, readable prose. This is facilitated by PROSENET, an approach which allows clean separation between the organization of the content of an analysis and its expression in English prose.
ATTENDING 系统旨在对医生的麻醉管理术前计划进行评估。在对医生的计划进行评估时,ATTENDING 与其他医疗决策系统不同,后者实际上是在试图告诉医生该怎么做。ATTENDING 的方法在临床上可能更容易被接受,并可能避免某些社会、医疗和医疗法律上的缺陷。要评估医生的计划,ATTENDING 必须面对三个基本问题。1)它必须能够灵活地探索患者管理的所有可能方法。“增强决策网络”的形式主义允许这样做。2)它必须能够明智地评估替代方法的相对风险和收益。基于三个详细描述的基本原理,概述了一种启发式风险分析方法。3)它必须生成一个潜在复杂的分析,以聚焦和可读的散文形式对计划进行评估。PROSENET 有助于实现这一点,这是一种允许在分析的内容组织与其在英语散文中的表达之间进行清晰分离的方法。