1. Expert Critiquing Systems.- 2. Artificial Intelligence in Medicine (AIM).- 3. The ATTENDING System: Anesthesiology.- 4. HT-ATTENDING: Essential Hypertension.- 5. VQ-ATTENDING: Goal-Directed Critiquing of Ventilator Management.- 6. PHEO-ATTENDING: Pheochromocytoma Workup and Conflicting Expertise.- 7. ESSENTIAL-ATTENDING: Building Expert Critiquing Systems.- 8. ESSENTIAL-ATTENDING's Knowledge Exerciser Program.- 9. Lessons Learned: Design Parameters for a Critiquing System.- 10. Future Directions.- Appendices.- References.
Computer technology has impacted the practice of medicine in dramatic ways. Imaging techniques provide noninvasive tools which alter the diagnostic process. Sophisticated monitoring equipment presents new levels of detail for both patient management and research. In most of these technology applications, the com puter is embedded in the device; its presence is transparent to the user. There is also a growing number of applications in which the health care provider directly interacts with a computer. In many cases, these applications are limited to administrative functions, e.g., office practice management, location of hospital patients, appointments, and scheduling. Nevertheless, there also are instances of patient care functions such as results reporting, decision support, surveillance, and reminders. This series, Computers and Medicine, will focus upon the direct use of infor mation systems as it relates to the medical community. After twenty-five years of experimentation and experience, there are many tested applications which can be implemented economically using the current generation of computers. More over, the falling cost of computers suggests that there will be even more extensive use in the near future. Yet there is a gap between current practice and the state-of the-art.