Miller R A, Masarie F E
Methods Inf Med. 1989 Nov;28(4):340-5.
The original goal of the INTERNIST-1 project, as formulated in the early 1970s, was to develop an expert consultant program for diagnosis in general internal medicine. By the early 1980s, it was recognized that the most valuable product of the project was its medical knowledge base (KB). The INTERNIST-1/QMR KB comprehensively summarizes information contained in the medical literature regarding diagnosis of disorders seen in internal medicine. The QMR program was developed to enable its users to exploit the contents of the INTERNIST-1/QMR KB in educationally, clinically, and computationally useful ways. Utilizing commonly available microcomputers, the program operates at three levels--as an electronic textbook, as an intermediate level spreadsheet for the combination and exploration of simple diagnostic concepts, and as an expert consultant program. The electronic textbook contains an average of 85 findings and 8 associated disorders relevant to the diagnosis of approximately 600 disorders in internal medicine. Inverting the disease profiles creates extensive differential diagnosis lists for the over 4250 patient findings known to the system. Unlike a standard printed medical textbook, the QMR knowledge base can be manipulated "on the fly" to format displays that match the information needs of users. Preliminary use of the program for education of medical students and medical house officers at several sites has met with an enthusiastic response.
20世纪70年代初制定的内科医生-1项目的最初目标是开发一个用于普通内科诊断的专家咨询程序。到20世纪80年代初，人们认识到该项目最有价值的产品是其医学知识库（KB）。内科医生-1/QMR知识库全面总结了医学文献中有关内科疾病诊断的信息。开发QMR程序是为了使其用户能够以在教育、临床和计算方面有用的方式利用内科医生-1/QMR知识库的内容。该程序利用常见的微型计算机，在三个层面上运行——作为一本电子教科书、作为一个用于组合和探索简单诊断概念的中级电子表格，以及作为一个专家咨询程序。这本电子教科书平均包含85项检查结果和8种相关疾病，与内科大约600种疾病的诊断有关。反转疾病概况会为系统已知的4250多项患者检查结果生成广泛的鉴别诊断列表。与标准的印刷医学教科书不同，QMR知识库可以“即时”操作，以格式化显示来匹配用户的信息需求。该程序在几个地点初步用于医学生和住院医生的教育，获得了热烈反响。
