Benefits Of Medical Expert Systems

Benefits of Medical Expert Systems

By: Joshua Bunz

Introduction   

Medical expert systems have not been used to determine medical problems but they will be able to. If they were used, they would be of great advantage to health of the entire world. Would be like have an infinite amount of doctors.

How They Work Expert System Shell User

Explanation

Interface

System

Case-Specific Data

Inference Engine Knowledge Knowledge Base Editor

Base

How They Work     

The user interface is where all the questions are asked about the patient. Explanation system tells us how a certain conclusion was obtained. The inference engine works with the knowledge base to find a sequence in which inferences are made. Knowledge base editor is used to modify the knowledge base. Knowledge base is the heart of the system and is usually in the form of if-then rules.

Expert Systems in Pakistan

This chart shows the population of Pakistan over the years.

Expert Systems in Pakistan Years

Doctors

Nurses

Nurses per 1,000 Doctors

1950

2,298

418

182

1955

3,923

963

245

1960

6,485

1,929

297

1965

10,682

2,945

276

1970

14,109

4,543

322

1975

17,887

6,144

343

1980

23,594

9,098

386

1985

30,044

10,529

350

1990

51,883

16,948

327

1995

69,691

22,299

320

2000

91,823

37,623

410

This chart shows the number of doctors and nurses. Shows that there is not enough doctors and nurses for the size of Pakistan.

Expert Systems in Pakistan The health personnel to population ratio in Pakistan has improved over the past two decades.  But, the majority of these health personnel are available in urban areas. The rural areas have still very low health professionals to population ratio.  The people in the rural areas do not have access to a lot of things the urban population does, these include: 

  

Education Medical assistance Food/Water

Expert Systems in Pakistan 





Medical expert systems are being introduced into countries like these to help doctors and nurses create a healthy population. Most people in rural areas of Pakistan are illiterate. The expert system would need to include text, pictures, and sound so the people could interact with the system. Even if expert systems have flaws, it would still be beneficial to have them in areas such as this, to enhance the lacking health care.

Updating the Knowledge Base    



There are new medications and new medical procedures being invented everyday. Doctors don’t have the time to learn all of the new medications and techniques. Someone should work on updating the knowledge base as a full time job. The expert system could be used as a second opinion so that patients would not have to travel to see another doctor. Doctors could be kept informed on new procedures and new tests as they become available.

Updating the Knowledge Base   

Should be able to update a knowledge base throughout the entire world. Doctors can learn about new and better procedures that were introduced in other countries. All doctors around the world can use the expert system to help them in their medical practice.

Peace Corps 

   

The Peace Corps is using medical expert systems to evaluate some background medical information about possible applicants. The system that is used is the On-line Health Status Review (HSR). It is a web based application managed by the vendor. It asks a number of yes/no questions about the applicants medical background. The answers are passed into the expert system to determine the applicants’ current health status and potention future medical problems.

Peace Corps 



 

The expert system will ensure that all applicants are in good enough health to participate in the Peace Corps. This is a preliminary medical assessment. This would save time for the Peace Corps medical team because they could eliminate candidates whose health is not up to standard, at the beginning of the process. If the applicant is found to be healthy, they will receive an invitation to have a final medical assessment. Another medical assessment is needed to make sure 100% that the applicant is healthy enough.

Expert System as Second Opinion     

CIGNA International Expatriate Benefits is a leading health care provider. It offers a web-based expert system second opinion service through the Cleveland Clinic. This program is used by health insurance companies to get a second opinion. This system provides added peace of mind. It enables patients from a worldwide location to obtain an expert medical second opinion without the burden of travel and added expense.

Expert System as Second Opinion  



E-Cleveland Clinic offers online diagnostics, by asking multiple questions about your health status. A nurse coordinator follows up with each patient by phone to make sure that the person understands everything and there was no confusion in the questions. Some insurance companies may want a second opinion for health and life insurance policies. This system is a way of getting it.

EasyDiagnosis    

EasyDiagnosis is another online medical expert system that anyone can use. It asks questions about the user’s symptoms in order to determine a diagnosis. Can be used to find out if you have something serious or if the illness is not life endangering. If only minor you don’t need to go to the emergency.   

Saves doctor’s time Saves money Saves traveling expenses.

EasyDiagnosis   

This system is very easy to use. You first choose a symptom that your having. For example chest pain, and specific questions will be asked about it: an example of a question: 

Where is the chest pain located? • A. Under the sternum (breastbone) or between the shoulder blades • B. Left chest in front ("under the heart") • C. "Pit of stomach" or in mid upper abdomen • D. Along the sides of the sternum (breastbone) where the ribs join it (parasternal) • E. None of the above • F. Unknown/not applicable

EasyDiagnosis 

Once all questions are answered a results page is displayed on the screen, looking something like this:  Condition/Disease Estimated probability  Nonspecific Chest Pain 97%  Chest Pain, GI Causes 2.4%  Coronary Disease or Heart Attack 0.1%  Costochondritis 0.1%  Chest Wall Syndrome 0.1%  Pleuritic Pain, Pleurisy, and Pulmonary Embolism 0.1%  Intercostal (Radicular) Pain 0.1%  Miscellaneous 0.1%

EasyDiagnosis 

The link to the webpage:  http://easydiagnosis.com/cgi-bin/expert/quest.cgi 

This expert system is not totally perfect. It has not been clinically tested but the information for the knowledge base came from doctors and different symptoms of diseases that they have seen.

Performance Improvement Advisor 



 

PIA is a medical expert system that helps physicians decide which type of diagnostic imaging test has the greatest chance of determining what the patient has. It relies on outcomes of previous tests, knowledge from medical literatures, past medical cases, and best practice guidelines. Physicians usually pick a test to do from their own experience but this expert system is much more efficient. Can be used to support physicians decisions just to make sure this is a good choice of test.

Performance Improvement Advisor 

 

This expert system will explain its decisions. It will show similar examples about how it concluded to a particular test that will give the best results. The physicians can change the knowledge base if they disagree with any of the rules. PIA also tells the user any medications that should be taken or instructions that they should follow prior to having the test done.

Performance Improvement Advisor 

 

This is a good way to reinforce a physicians idea of which test to do or let the physician know what test to use if they are not sure. This would save money spent on useless tests and would reduce the amount of wait time for tests. The main idea is to minimize the number of tests by doing the correct one first and only.

Medical Training Purposes  



Expert medical systems can be used for medical training. Medical students can input various symptoms, patient history, and other chronic diseases that the patient may have, and the system will formulate the disease processes that could be the cause of the symptoms. The expert medical system can offer potential treatment programs, possible complications, and necessary medical follow-up for the patient, so that the student can learn how to care for their future patients.

Mobile System for Supporting Emergency Triage  





The MET system can be used for assisting in triaging patients in the Emergency Department. The patient could follow instructions on the computer themselves, and answer the necessary questions in order to reduce the workload on the triage nurses. Based on the responses to the questions, the MET system will assign a triage code to each patient using decision rules from the knowledge base. This triage code reflects how critical the patient is, and therefore, how quickly the patient needs to be seen by the doctor. The most critical patients would be moved to the top of the list.

Conclusion  





Expert systems are efficient computer programs that are beneficial in the medical field. There are clips on the news all the time about the lack of doctors and nurses, and medical expert systems would assist in providing expert, current care. Online expert system can be used to reduce amount of people going to the emergency room with minor health problems, and help to identify those with more severe diseases. Expert medical systems can ensure that users receive the most up-to-date medical information in a timely manner.

Conclusion     

Expert systems should be able to make decision about what medical problem a patient has. Add more and more cases to the knowledge and the system will get information that many doctor’s know. Update the knowledge with more and more doctors opinions. These systems give a percentage of the answer and are not completely accurate. This is also true for doctors. If a case has been seen before a doctor can answer it easy, a knowledge can store more examples of diseases than any doctor can.

Questions?

References 

EasyDiagonosis ( http://easydiagnosis.com/ )



Business Expatriate Health Benefits Insurance ( http://www.insurance-canada.ca/profproducts/healthexpatP/CIGNA-Second-Opinion-5 )



EXPERT SYSTEMS AND OPEN SYSTEMS IN MEDICAL ARTIFICIAL INTELLIGENCE (http://matrixcognition.com/ORIGIN02.HTM#Introduction)



CHEST: Medical Expert Systems. Who Needs Them? ( http://www.chestjournal.org/cgi/reprint/91/1/3.pdf )



The Role of Medical Expert Systems in Pakistan ( http://www.waset.org/pwaset/v27/v27-50.pdf )