Designing for Explanation in Health Care Applications of Expert Systems

Keith W Darlington

doi:10.1177/2158244011408618

Abstract

A great deal has been written about the role of clinical decision support systems in medicine in recent years—an important category of which are expert systems. Expert systems would normally contain an explanation module—the subject of a great deal of research interest in the 1980s when the main problem-solving task for medical expert systems was diagnostics. However, expert systems nowadays are more likely to perform tasks other than diagnosis, yet the role of explanation in expert systems has been largely ignored in the health care literature since this time. Furthermore, user requirements can vary considerably in the health care domain and may include physicians, medical researchers, administrators, and patients. Such user groups would have differing levels of knowledge and goals, which would impact on the type of explanatory support provided by the system. This article examines the potential benefits of explanation facilities for a range of clinical tasks and also considers the ways in which explanation facilities may be delivered so as to be of benefit to these categories of health care user for these tasks.

Highlights

Much had been written in the 1980s about the role of explanation facilities in medical diagnostic expert systems: MYCIN (Clancey, 1983; Shortliffe, 1981) and PUFF (Aikins, Kunz, Shortliffe, & Fallat, 1983) were both prototype medical expert systems of interest because of their explanation
This article recognizes the changing role of health care expert systems tasks over the past 30 years. One of their main features—explanation facilities—has been largely ignored in health care systems—despite the potential benefits that can be derived from their inclusion
This article has shown that there is much potential for the use of explanation facilities for problem-solving tasks other than diagnostics— the only problem-solving task that was used in the early medical expert systems

Summary

Introduction

Much had been written in the 1980s about the role of explanation facilities in medical diagnostic expert systems: MYCIN (Clancey, 1983; Shortliffe, 1981) and PUFF (Aikins, Kunz, Shortliffe, & Fallat, 1983) were both prototype medical expert systems of interest because of their explanation. Understanding the difficulties of implementing explanation facilities in expert systems requires knowledge of the way that both components work together as described .

Results

Conclusion