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Internist-I
INTERNIST-I was a broad-based computer-assisted diagnostic tool developed in the early 1970s at the University of Pittsburgh as an educational experiment. The system was designed to capture the expertise of just one man, Jack D. Myers, MD, chairman of internal medicine in the University of Pittsburgh School of Medicine. The Division of Research Resources and the National Library of Medicine funded INTERNIST-I. Other major collaborators on the project included Randolph A. Miller and Harry E. Pople.
==Development ==
INTERNIST-I is the successor of the DIALOG system. For ten years, INTERNIST-I was the centerpiece of a Pittsburgh course entitled “The Logic of Problem-Solving in Clinical Diagnosis.” In consultation with faculty experts, much responsibility for data entry and updating of the system fell to the fourth-year medical students enrolled in the course. These students encoded the findings of standard clinicopathological reports. By 1982, the INTERNIST-I project represented fifteen person-years of work, and by some reports covered 70-80% of all the possible diagnoses in internal medicine.
Data input into the system by operators included signs and symptoms, laboratory results, and other items of patient history. The principal investigators on INTERNIST-I did not follow other medical expert systems designers in adopting Bayesian statistical models or pattern recognition. This was because, as Myers explained, “The method used by physicians to arrive at diagnoses requires complex information processing which bears little resemblance to the statistical manipulations of most computer-based systems.” INTERNIST-I instead used a powerful ranking algorithm to reach diagnoses in the domain of internal medicine. The heuristic rules that drove INTERNIST-I relied on a partitioning algorithm to create problems areas, and exclusion functions to eliminate diagnostic possibilities.
These rules, in turn, produce a list of ranked diagnoses based on disease profiles existing in the system’s memory. When the system was unable to make a determination of diagnosis it asked questions or offered recommendations for further tests or observations to clear up the mystery. INTERNIST-I worked best when only a single disease was expressed in the patient, but handled complex cases poorly, where more than one disease was present. This was because the system exclusively relied on hierarchical or taxonomic decision-tree logic, which linked each disease profile to only one “parent” disease class.
抄文引用元・出典: フリー百科事典『 ウィキペディア（Wikipedia）』
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