Giuse D A, Giuse N B, Miller R A
Vanderbilt University, Nashville, TN, USA.
J Am Med Inform Assoc. 1995 Sep-Oct;2(5):297-306. doi: 10.1136/jamia.1995.96073832.
Evaluate the effects of long-term maintenance activities on existing portions of a large internal medicine knowledge base.
Five physicians who were not among the original developers of the knowledge base independently updated a total of 15 QMR disease profiles; each updated submission was modified by a review of group serving as the "gold standard, " and the pre- and post-study versions of each updated disease profile were compared.
Numbers and types of changes, defined as any difference between the original version and the final version of a disease profile; reason for each change; and bibliographic references cited by the physicians as supporting evidence.
A total of 16% of all entries were modified by the updating process; up to 95% of the entries in a disease profile were affected. The two most common modifications were changes to the frequency of an entry, and creation of a new entry. Laboratory findings were affected much more often than were history, symptom, or physical exam findings. The dominant reason for changes was appearance of new evidence in the medical literature. The literature cited ranged from 1944 to the present.
This study provides an evaluation of the rate of change within the QMR medical knowledge base due to long-term maintenance. The results show that this is a demanding activity that may profoundly affect certain portions of a knowledge base, and that different types of knowledge (e.g., simple laboratory vs expensive or invasive laboratory findings) are affected by the process in different ways.
评估长期维护活动对大型内科知识库现有内容的影响。
五位并非该知识库原始开发者的医生独立更新了总共15个QMR疾病档案；每个更新后的提交内容都由作为“金标准”的评审小组进行修改，并对每个更新后的疾病档案的研究前和研究后版本进行比较。
变化的数量和类型，定义为疾病档案原始版本与最终版本之间的任何差异；每次变化的原因；以及医生引用作为支持证据的参考文献。
在更新过程中，所有条目中共有16%被修改；一个疾病档案中多达95%的条目受到影响。最常见的两种修改是条目的频率变化和新条目的创建。实验室检查结果比病史、症状或体格检查结果受影响的频率高得多。变化的主要原因是医学文献中出现了新证据。引用的文献范围从1944年至今。
本研究对QMR医学知识库因长期维护而产生的变化率进行了评估。结果表明，这是一项要求很高的活动，可能会对知识库的某些部分产生深远影响，并且不同类型的知识（例如，简单的实验室检查结果与昂贵或侵入性的实验室检查结果）受该过程的影响方式不同。
