Wiener F, Vinaver J
Int J Biomed Comput. 1977 Jul;8(3):203-15. doi: 10.1016/0020-7101(77)90004-6.
A system for the simulation of clinical reasoning was applied to the evaluation of patient data in nephrological diseases. The system allows the physician to computerise the medical logic in his area of specialisation, to prepare suitable protocols for recording clinical observations, to analyse the patient data for assessing his present clinical status and to plan appropriate diagnostic and therapeutic interventions. The medical logic is expressed in modular form as a series of inferences to be confirmed or rejected on the basis of Boolean combinations of clinical findings and previous inferences. The acceptable Boolean combinations are formulated in terms of threshold logic. The computer programs produce alphabetical lists of the clinical findings appearing in the medical logic, which are organised by the physician into data acquisition protocols appropriate to each phase of clinical activity. The system was run on a series of 22 patients hospitalised in the Department of Nephrology. The patient status reports produced by the computer were in substantial agreement with the assessment of a senior nephrologist. The protocols assured a more complete and accurate recording of patient data than that appearing in the routine patient chart. The program was of value in standardising patient examinations and in the training of new medical staff.
一种临床推理模拟系统被应用于肾脏疾病患者数据的评估。该系统允许医生将其专业领域内的医学逻辑计算机化，制定记录临床观察结果的合适方案，分析患者数据以评估其当前临床状况，并规划适当的诊断和治疗干预措施。医学逻辑以模块化形式表示为一系列基于临床发现和先前推理的布尔组合需确认或否定的推论。可接受的布尔组合依据阈值逻辑制定。计算机程序生成医学逻辑中出现的临床发现的字母列表，医生将其整理成适合临床活动各阶段的数据采集方案。该系统在肾病科住院的一系列22名患者身上运行。计算机生成的患者状态报告与一位资深肾病专家的评估基本一致。这些方案确保了比常规患者病历中更完整、准确地记录患者数据。该程序在使患者检查标准化以及培训新医务人员方面具有价值。
