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Medical Software Technology: “Expert Systems”

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Arnie1 copyI work in the medical software industry, and quite often, people will ask me what is involved with that. In my mind, medical software involves many things, including image scanning, electronic health records, bioinformatics, and much to my surprise artificial intelligence technologies such as “expert systems”! Today, I would like to talk about this hot topic in the medical software industry – “expert systems”.

So what is an expert system? Wikipedia gives the definition that it is “software that attempts to reproduce the performance of one or more human experts.” And also, “an expert system uses a knowledge base (or rulebase) and an inference engine to simulate the reasoning process that a human expert uses to analyze a problem and arrive at a conclusion.” This might be accomplished using “confidences” or certainty factors that are meant to imitate the confidences humans use in reasoning, rather than use the strict probability rules of mathematics.

The architecture behind expert systems is not too complicated. Basically, an expert system just consists of a very large knowledge base (or rulebase), usually consisting of “IF / THEN” type statements, and an inference engine that might operate by using forward or backward chaining logic.

The end-user will usually be required to answer a series of questions, and the large knowledge base will then be queried in order to spit out some sort of conclusion. For example, the conclusion could be a disease diagnosis based on a number of symptoms that the patient has. Or, an expert system could be designed to alert a pharmacist of potentially harmful drug interactions when entering a prescription order.

I wouldn’t be surprised if the idea of these expert systems was met with quite a bit of skepticism. People might wonder how successful these systems really are in practice. In my mind, these systems could be very helpful to doctors and nurses in the decision making process, but should not be used to try and replace these experts.

Here is a list of some common pitfalls:

  • The systems are prone to making errors that humans would easily spot (i.e. lack of common sense)
  • The knowledge base has to be constantly updated and maintained to keep it up-to-date
  • Too many alerts and reminders could overwhelm doctors and nurses, causing the alerts to be ignored altogether
  • Workflow integration difficulties – will the system slow the physician down?

But here are some benefits:

  • Expert systems can catch things a human might forget
  • Provides consistency to patient care
  • Chances for negative drug interactions or wrong diagnoses can be avoided
  • The system can be kept up-to-date with the latest research and findings

Check out the resources I have listed below to learn more!

https://en.wikipedia.org/wiki/Medical_software

https://en.wikipedia.org/wiki/Expert_System

https://en.wikipedia.org/wiki/Clinical_decision_support_system

https://www.ciap.health.nsw.gov.au/hospolic/stvincents/1993/a04.html

https://www.ncbi.nlm.nih.gov/pubmed/12925543

(full text)
https://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pubmed&pubmedid=12925543

Push vs. Pull on the Internet

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A long time ago, I don’t think people gave push vs. pull systems too much thought when it came to the internet.  You searched for information via a search engine, visited web sites and checked your email.  Now, however, it seems that we are presented with two overall systems for accessing the information we want.

Push vs. Pull (as defined by me):

Push: The internet or program pushes the information to YOU.

Pull: YOU go and search for the information you want or need.

If you are interested to know how Wikipedia defines it (as marketing or supply chain terms) visit https://en.wikipedia.org/wiki/push-pull_strategy

So based on the definitions given above, let’s look at a few examples:

– RSS Feeds
– SharePoint intranet portal (with or without alerts)
– FaceBook
– Email
– Internet Searching

Internet Technology Push / Pull Reason
RSS Feeds Push You sign up for which RSS feeds you want to receive, by using your favourite aggregator (such as the built-in Latest Headlines aggregator of Firefox, or a job search aggregator, or Bloglines, FeedDemon, or Google Reader ).
SharePoint Intranet Portal Push or Pull depending on whether or not you use alerts If you are using SharePoint for your company intranet or knowledgebase portal, this is basically a pull system, unless you are using alerts to alert you of new content added – then it becomes a push system.
FaceBook Push In my opinion, FaceBook is a push system, because of the frequency in which people update their status updates and add content.
Email Push Email is a push system, especially if you receive newsletters or articles via email, and it also depends on the frequency in which you check it.
Internet Searching Pull Google and Internet Searching is pull, since you are entering in a sequence of search terms, and pulling in the information you requested.

Find me on Twitter: jacbird

Various Uses of XML

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It’s 11:00 pm, on a Friday night…….so why not write an article about the various uses of XML? You’ve probably heard that term before, and I’m sure you will hear it again. In my mind, it’s a way to make the information displayed on the internet more concise, searchable, and organized.

I first became interested in XML when I found out that it’s something technical writers should know, and that it had something to do with RSS feeds.

RSS Feeds:

RSS aggregator programs read RSS feeds on news sites and blog sites to allow you, the reader, to become aware of new and recent information without having to do it yourself. The RSS aggregator reads the RSS feed which is written in XML. The funny thing, is that the RSS aggregator program reads the feed in XML, but you could too, since XML is human-readable! Of course though, you’re not a robot, and so I’m sure you don’t want to be the one to scan all those feeds and see which ones are new, and then display them to the internet.

MathML:

Anything about math is cool, right? Well, now they’ve figured out how to use XML to describe math formulas and bring them to the World Wide Web. And you thought you were done with math after first year calculus.

I’m pleased to tell you that the XML not only describes how math formulas should be displayed (presentation) but even what the different formula components mean (content). Read more about it at https://www.w3.org/Mathand https://en.wikipedia.org/wiki/MathML

Searching:

You can use XML to define the type of information contained in a document, and thus make that information easier to search. That is because unlike HTML, XML describes the information rather than just presents it. So for instance, you could use XML to denote that Chrysanthemum is a book title rather than a plant by using a book title tag <book_title>Chrysanthemum</book_title>.

Now a web robot would know that in this instance, Chrysanthemum is a book title and not a flower.

Other Uses:

Now what I will do, is list a few other uses of XML and send you off to learn more about them on your own. I know I’ve made XML sound so exciting, so you won’t be able to wait any longer will you?

DITA (Darwin Information Typing Architecture); SVG (Scalable Vector Graphics); Databases; AJAX (Asynchronous Javascript and XML).

Find me on Twitter: jacbird