Medical decision-support systems and the concept of context

Medical decision-support systems are of necessity multi-contextual in nature. There are always at least two contexts involved in the use of such systems: the expert knowledge-provider context and the end-user context. To show this, we present examples of context-dependent aspects significant to the use of decision-support systems. The existence of discrepancies between the contexts threatens to disrupt the rationale for using decision-support systems: for the system to transfer knowledge from the expert to the end-user. Both theoretical and empirical studies show that such discrepancies exist and that they may be detrimental to the use of decision-support systems. Systems must thus give support in interpreting the output produced by the system in the context of the end-user.

[1]  H A Heathfield,et al.  Philosophies for the Design and Development of Clinical Decision-Support Systems , 1993, Methods of Information in Medicine.

[2]  P. Hjortdahl,et al.  General practice—time for a new definition , 2000, BMJ : British Medical Journal.

[3]  John McCarthy,et al.  Generality in artificial intelligence , 1987, Resonance.

[4]  D. Sackett,et al.  Educational package on hypertension for primary care physicians. , 1984, Canadian Medical Association journal.

[5]  J. Kassirer Medicine at the turn of the century. , 2000, The Annals of thoracic surgery.

[6]  Varol Akman,et al.  Rethinking context as a social construct , 2000 .

[7]  Daniel Karlsson,et al.  Terms used to describe urinary tract infections – the importance of conceptual clarification , 2003, APMIS : acta pathologica, microbiologica, et immunologica Scandinavica.

[8]  Aldo Gangemi,et al.  Integrating Medical Terminologies with ONIONS Methodology , 1997 .

[9]  S. Garrod,et al.  Conversation, co-ordination and convention: an empirical investigation of how groups establish linguistic conventions , 1994, Cognition.

[10]  Carter Kc Koch's Postulates in Relation to the Work of Jacob Henle and Edwin Klebs , 1985 .

[11]  O Wigertz,et al.  A study of the usage of a decision-support system for infective endocarditis , 2000, Medical informatics and the Internet in medicine.

[12]  D. Karlsson,et al.  Building a concept system to structure the contents of a decision support system--a grounded theory study of concepts in the knowledge domain of urinary tract infection. , 2001, Medical informatics and the Internet in medicine.

[13]  R. Guha Contexts: a formalization and some applications , 1992 .

[14]  K. C. Carter,et al.  Koch's postulates in relation to the work of Jacob Henle and Edwin Klebs. , 1985, Medical History.

[15]  Herbert H. Clark,et al.  Grounding in communication , 1991, Perspectives on socially shared cognition.

[16]  Terry Winograd,et al.  Thinking Machines: Can There Be? Are We? , 1990, Informatica.

[17]  Arne Naess,et al.  Communication and argument : elements of applied semantics , 1968 .

[18]  Varol Akman,et al.  Steps Toward Formalizing Context , 1996, AI Mag..

[19]  S. Falkow What is a pathogen , 1997 .