The Role of Knowledge Based Systems in Medicine

Abstract

We examine some paradigms for a comprehensive evaluation of Knowledge Based Systems (KBSs) in the health field to envisage a methodology for the proper design of such systems.The physician is considered here for his function as a manager of knowledge (namely: patient’s data, acquired expertise, “public” medical knowledge, common sense). The KBS technology is consequently an intellectual tool among the media available to the physician in his environment.The aim of a KBS may be stated as to improve the performance of a professional in tackling defined health problems, by supporting him in the management of the knowledge. In this respect, the known experiences about the assessment of the performance of Medical KBSs seem rather narrow in their objectives. Therefore, more comprehensive contexts for the evaluation are recommended. Three levels are defined: i) efficiency of the system in itself removed from its context; ii) overall effectiveness in the user’s environment; iii) impact of the KBS technology on health. We suggest a cooperative effort to drive and support the evaluations: to establish detailed guidelines, to give rise to a collection of reviews about each system and to maintain a register of applications.