Wiener F, Groth T, Mortimer O, Hallquist I, Rane A
Unit of Biomedical Systems Analysis, Uppsala University, Sweden.
Comput Methods Programs Biomed. 1989 Jun;29(2):115-28. doi: 10.1016/0169-2607(89)90079-5.
The expert system shell SMR has been enhanced to include information system routines for designing data screens and providing facilities for data entry, storage, retrieval, queries and descriptive statistics. The data for inference making is abstracted from the data base record and inserted into a data array to which the knowledge base is applied to derive the appropriate advice and comments. The enhanced system has been used to develop an intelligent information system for monitoring serum drug levels which includes evaluation of temporal changes and production of specialized printed reports. The module for digoxin has been fully developed and validated. To demonstrate the extension to other drugs a module for phenytoin was constructed with only a rudimentary knowledge base. Data from the request forms together with the S-digoxin results are entered into the data base by the department secretary. The day's results are then reviewed by the clinical pharmacologist. For each case, previous results may be displayed and are taken into account by the system in the decision process. The knowledge base is applied to the data to formulate an evaluative comment on the report returned to the requestor. The report includes a semi-graphic presentation of the current and previous results and either the system's interpretation or one entered by the pharmacologist if he does not agree with it. The pharmacologist's comment is also recorded in the data base for future retrieval, analysis and possible updating of the knowledge base. The system is now undergoing testing and evaluation under routine operations in the clinical pharmacology service. It is a prototype for other applications in both laboratory and clinical medicine currently under development at Uppsala University Hospital. This system may thus provide a vehicle for a more intensive penetration of knowledge-based systems in practical medical applications.
专家系统外壳SMR已得到增强，纳入了用于设计数据屏幕以及提供数据录入、存储、检索、查询和描述性统计功能的信息系统例程。用于推理的数据从数据库记录中提取出来，并插入到一个数据数组中，知识库应用于该数组以得出适当的建议和评论。增强后的系统已被用于开发一个监测血清药物水平的智能信息系统，该系统包括对时间变化的评估以及生成专门的打印报告。地高辛模块已全面开发并经过验证。为展示该系统对其他药物的适用性，构建了一个只有基本知识库的苯妥英模块。请求表中的数据以及地高辛的检测结果由科室秘书录入数据库。然后由临床药理学家查看当天的结果。对于每个病例，之前的结果可以显示出来，并且系统在决策过程中会予以考虑。知识库应用于这些数据，以对返回给请求者的报告形成评估性评论。报告包括当前和之前结果的半图形展示，以及系统的解读，或者如果药理学家不同意系统解读，则为其输入的解读。药理学家的评论也会记录在数据库中，以备将来检索、分析以及可能对知识库进行更新。该系统目前正在临床药理服务的日常操作中进行测试和评估。它是乌普萨拉大学医院目前正在开发的实验室和临床医学其他应用的一个原型。因此，该系统可能为基于知识的系统在实际医疗应用中的更深入渗透提供一个载体。
