Collaborative Project Abstracts REFERENCES: 1. Holtzman, S.: A Decision Aid for Patients with End-Stage Renal Disease, Department of Engineering-Economic Systems, Stanford University, Stanford, California, 1983. 2. Holtzman, S.:Oa the Use of Formal Methods for Decision Making, Department of Engineering-Economic Systems, Stanford University, 1985. 3. (*) Holtzman, S.Jatelligent Decision Systems, Ph.D. Dissertation, Department of Engineering-Economic Systems, Stanford University, 1985. E. H. Shortliffe 326 Privileged Communication Stanford Project: Principal Investigators: Collaborative Project Abstracts REFEREE Project Bruce G. Buchanan, Ph.D. Computer Science Department 70! Welch Road Stanford University Palo Alto, California .94304 (415) 497-0935 (BUCHANAN@SUMEX-AIM) Byron W. Brown Ph.D. Department of Biostatistics Stanford University Medical Center Stanford, California 94305 (BWROWN@SUMEX-AIM) Daniel E. Feldman, M.D., Ph.D. Department of Medicine Stanford University Medical Center Stanford, California 94305 (DFELDMAN@SUMEX-AIM) The goal of this project is two-fold: (a) use existing AI methods to implement an expert system that can critique medical journal articles on clinical trials, and (b) in the long term, develop new AI methods that extract new medical knowledge from the clinical trials literature. stages. In order to accomplish (a) we are building the system in three 1. System I will assist in the evaluation of the quality of a single clinical trial. The user will be imagined: to be the editor of a journal reviewing a manuscript for publication, but the program will be tested on a variety of readers, including clinicians, medical scientists, medical and graduate students, and clerical help. . System IT will assist in the evaluation of the effectiveness of the treatment or intervention examined in a single published clinical trial. The user will be imagined to be a clinician interested in judging the efficacy of the treatment being tested in the trial. . System III will assist in the evaluation of the effectiveness of a single treatment examined in a number of published clinical trials. Privileged Communication 327 E. H. Shortliffe Collaborative Project Abstracts National AIM Project: Computer-Aided Diagnosis of Malignant Lymph Node Diseases (PATHFINDER) Principal Investigator: Bharat Nathwani, M.D. Department of Pathology HMR 204 2025 Zonal Avenue University of Southern California School of Medicine Los Angeles, California 90033 (213) 226-7064 (NATHWANI@SUMEX-AIM) Lawrence M. Fagan, M.D., Ph.D. Department of Medicine Stanford University Medical Center - Room TC135 Stanford, California 94305 (415) 497-6979 (FAGAN@SUMEX-AIM) We are building a computer program, called PATHFINDER, to assist in the diagnosis of lymph node pathology. The project is based at the University of Southern California in collaboration with the Stanford University Medical Computer Science Group. A pilot version of the program provides diagnostic advice on 80 common benign and malignant diseases of the lymph node based on 150 histologic features. Our research plans are to develop a full-scale version of the computer program by substantially increasing the quantity and quality of knowledge and to develop techniques for knowledge representation and manipulation appropriate to this application area. The design of the program has been strongly influenced by the INTERNIST/CADUCEUS program developed on the SUMEX resource. SOFTWARE AVAILABLE ON SUMEX PATHFINDER-- A_ version of the PATHFINDER program is available for experimentation on the DEC 2060 computer. This version is a pilot version of the program, and therefore has not been completely tested. E. H. Shortliffe 328 Privileged Communication Collaborative Project Abstracts National AIM Project: RXDX Project Principal Investigators: Robert Lindsay, Ph.D. Michael Feinberg, M.D., Ph.D. Manfred Kochen, Ph.D. University of Michigan Ann Arbor, Michigan We are developing a prototype expert system that could act as a consultant in the diagnosis and management of depression. Heaith professionals will interact with the program as they might with a human consultant, describing the patient, receiving advice, and asking the consultant about the rationale for each recommendation. The program uses a knowledge base constructed by encoding the clinical expertise of a skilled psychiatrist in a set of rules and other knowledge structures. It will use this knowledge base to decide on the most likely diagnosis (endogenous or nonendogenous depression), assess the need for hospitalization, and recommend specific somatic treatments when this is indicated (e.g., tricyclic antidepressants). The treatment recommendation will take into account the patient's diagnosis, age, concurrent illnesses, and concurrent treatments (drug interactions). Privileged Communication 329 E. H. Shortliffe Collaborative Project Abstracts References 1. Barr, Avron, Paul R. Cohen and Edward A. Feigenbaum. The Handbook of Artificial Intelligence, Volumes I, II, and [II. William Kaufmann, Inc., Los Altos, CA, 1981 and 1982. 2. Bennett, James S. and Robert S. Engelmore. "SACON: A Knowledge-Based Consultant for Structural Analysis." [JCAI Proceedings 6 (1979), 47 - 49. 3. Bobrow, D., ed... Artificial Intelligence, An International Journal: Special Volume on Qualitative Reasoning about Physical Systems. North Holland Publishing Company, Amsterdam, 1984. 4, Bryson, Y.J., Dillon, M., Lovett, M., et al. "Treatment of first episodes of genital herpes simplex infection with oral acyclovir.” New England Journal of Medicine 308 (1983), 916-921. 5. Buchanan, B.G. 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REFEREE and RULECRITIC: Two prototypes for assessing the quality of a medical paper. Master Th., Stanford University, 1984. 24. Hart, P.O., Duda, R.O., Einaudi, M.T. "PROSPECTOR -- A Computer-based Consultation System for Mineral Exploration." Mathematical Geology 10, 5 (1978). 25. Hayes-Roth, B. Flexibility in executive processes. Tech. Rept. N-1170-ONR, Santa Monica, Ca.: Rand Corporation, 1980. 26. Hayes-Roth, B. The blackboard architecture: A general framework for problem- solving? Tech. Rept. HPP-83-30, Stanford, Ca.: Stanford University, 1983. 27. Hayes-Roth, B. BB1: An architecture for blackboard systems that control, explain, and learn about their own behavior. Tech. Rept. HPP-84-16, Stanford, Ca.: Stanford University, 1984. 28. Hayes-Roth, B. “A blackboard architecture for control.” Artificial Intelligence Journal in press (1985). 29. Hayes-Roth, B., and Hewett, M. Learning Control Heuristics in a Blackboard Environment, Tech. Rept. HPP-85-2, Stanford, Ca: Stanford University, 1985. 30. Hayes-Roth, B., Hayes-Roth, F., Rosenschein, S., and Cammarata, S. "Modelling planning as an incremental, opportunistic process." Proceedings of the International Joint Conference on Artificial Intelligence 6 (1979), 375-383. 31. Hayes-Roth, F., Waterman, D. A. & Lenat, D. B. (Eds.). Building Expert Systems. Addison-Wesley, Reading, MA, 1983. Privileged Communication 331 E. H. Shortliffe Collaborative Project Abstracts 32. Hewitt, C., P. Bishop, and R. Steiger. A Universal Modular ACTOR Formalism for Artificial Intelligence. IJCA13, 1973, pp. 235-45. 33. Hickam, D.H., Shortliffe, E.H., Bischoff, M.B., Scott, A.C., Jacobs, C.D. A Study of the Treatment Advice of a Computer-Based Cancer Chemotherapy Protocol Advisor. KSL 85-21. Submitted for publication, May 1985 34. Jardetzky, O. A Method for the Definition of the Solution Structure of Proteins from NMR and Other Physical Measurements: The LAC-Repressor Headpiece. Proceedings of the International Conference on the Frontiers of Biochemistry and Molecular Biology, Alma Alta, June 17-14, 1984, 1984. 35. Kent, D.L., Shortliffe, E.H., Carlson, R.W., Bischoff, M.B., Jacobs, C.D. Improvements in Data Collection Through Physician Use of a Computer-Based Chemotherapy Treatment Consultant. KSL 85-22. Submitted for publication, March 1985 36. Kunz, J.C., Fallat, R.J., McClung, D.H., Osborn, J.J., Votteri, B.A., Nii, H.P., Aikins, J.S., Fagan, L.M., Feigenbaum, E.A. A physiological rule-based system for interpreting pulmonary function test results. Proceedings of Computers in Critical Care and Pulmonary Medicine, 1979, pp. 375-379. 37. Keith A. Lantz et. al. V - System 4.1 Reference Manual. December 1, 1983. Computer Systems Laboratory, Stanford University. 38. K. A. Lantz, K. D. Gradischnig, J. Feldman, and R. Raschid. "Rochester's Intelligent Gateway.” Computer 10, 15 (October 1985), 54-68. 39. Keith A. Lantz, David R. Cheriton, and William I. Nowicki. Third Generation Graphics for Distributed Systems. Computer Systems Laboratory. Stanford University, December 21, 1982 40. PJ. Leach et al. “The Architecture of an Integrated Local Network.” /EEE Journal on Software and Applications ?, SAC-1,5 (November 1983), 842-857. 41. Lederberg, J. "Digital Communications and the Conduct of Science: The New Literacy.” Proceedings of the IEEE 66, 11 (1978). 42. Levy, R.I. “Current status of cholesterol controversy.” Am J Med 74 (1983), 1-4. 43. Lindsay, R. K., Buchanan, B. G., Feigenbaum, E. A., and Lederberg, J... Applications of Artificial Intelligence for Organic Chemistry: The DENDRAL Project. McGraw-Hill, New York, 1980. 44, MacMahon, B., Yen, S., Trichopoulos, D., et al. “Coffee and cancer of the pancreas." New England Journal of Medicine 304 (1981), 630-633. 45. Masinter, Larry M. Interlisp VAX: A Report. Tech. Rept. HPP-81-14 or STAN- CS-81-879, Heuristic Programming Project, Stanford University, 1981. 46. McCarthy, J.M. "Circumscription -- A Form of Nonmonotonic Reasoning.” Artificial Intelligence 13 (April 1980). E. H. Shortliffe 332 Privileged Communication Collaborative Project Abstracts 47. McDermott, J. "Rl: The Formative Years." The Al Magazine 2, 2 (1981). summer 48. McDermott, J. "Rl: A rule-based configurer of computer systems.” Artificial Intelligence 9, 1 (1982), 39-88. 49. Miller, PL. “ATTENDING: Critiquing a Physician's Management Plan." /EEE Transactions on Pattern Analysis and Machine Intelligence 5 (1983), 449-461. 50. Musen, M., Langlotz, C., Fagan, L., Shortliffe, EH. Motivations for Restructuring a Rule-based Consultation System. Proceedings of the American Association for Medical Science and Informatics Congress, 1985. KSL 85-17 51. Newell, A. and Sprouill, R. F. "Computer Networks - Prospects for Scientists.” Science 215, 4534 (1978). 52. Newell, A. Reasoning, problem solving and decision processes: The problem space as a fundamental category. 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A Framework for Distributed Problem Solving. UMI Research Press, Ann Harbor, Michigan, 1981. 68. Van Melle, W., Scott, A.C., Bennett, J.S., and Peairs, M.A.S. The EMYCIN Manual. Tech. Rept. KSL-80-11, Knowledge Systems Laboratory, Stanford University, 1980. Superseded by KSL~-81-16 69. Winston, P.. Artificial Intelligence, 2nd ed. Addison-Wesley, Reading, MA, 1984. 70. Zwaenepoel, Willy. Message Passing on a Local Network. Ph.D. Th., Stanford University, 1984, E. H. Shortliffe 334 Privileged Communication