Wiener F, Lev L, Kovant A, Robinson E
Clin Radiol. 1977 May;28(3):333-7. doi: 10.1016/s0009-9260(77)80192-x.
In order to provide a common basis for treatment decisions and the future evaluation of breast cancer therapy, the breast cancer protocol used in our clinic was formulated for the computer. A system for the simulation of clinical reasoning was used which allows the physician to express the medical logic as a series of inferences to be confirmed or rejected on the basis of Boolean combinations of medical criteria. The system enables the physician to rearrange these criteria into a questionnaire for complete and accurate recording of patient data. These data are then fed into the computer to produce a patient status report and treatment recommendations. The data from 26 patients in various stages of breast cancer have been processed by the computer and the computer's conclusions compared to the assessment made by a junior physician in our department. In three cases the staging was not identical, in 15 cases the treatment decisions were not identical and in all cases investigations were left out by the physician. The system has been of considerable value in standardising patient examination and treatment and in training inexperienced physicians.
为了为乳腺癌治疗决策及未来评估提供共同基础，我们诊所使用的乳腺癌治疗方案已被编制成计算机程序。采用了一种临床推理模拟系统，该系统允许医生将医学逻辑表达为一系列基于医学标准的布尔组合来确认或否定的推理。该系统使医生能够将这些标准重新排列成一份问卷，以完整准确地记录患者数据。然后将这些数据输入计算机，生成患者状况报告和治疗建议。计算机已处理了26例处于不同乳腺癌阶段患者的数据，并将计算机得出的结论与我们科室一位低年资医生的评估进行了比较。在3例中分期不同，在15例中治疗决策不同，且在所有病例中该医生都遗漏了一些检查项目。该系统在规范患者检查和治疗以及培训经验不足的医生方面具有相当大的价值。
