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Computer-Based Medical Consultations: MYCIN

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This text is a description of a computer-based system designed to assist physicians with clinical decision-making. This system, termed MYCIN, utilizes computer techniques derived principally from the subfield of computer science known as artificial intelligence (AI). MYCIN's task is to assist with the decisions involved in the selection of appropriate therapy for patients with infections.

MYCIN contains considerable medical expertise and is also a novel application of computing technology. Thus, this text is addressed both to members of the medical community, who may have limited computer science backgrounds, and to computer scientists with limited knowledge of medical computing and clinical medicine. Some sections of the text may be of greater interest to one community than to the other. A guide to the text follows so that you may select those portions most pertinent to your particular interests and background.

The complete book in a single file.



Artificial intelligence meets natural stupidity

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Anyone interested in acting as editor for a special issue of the Newsletter devoted to a particular topic in A! is invited to contact the Editor. Letters to the Editor will be considered as submitted for publication unless they contain a request to the contrary. Technical papers appearing in this issue are unrefereed working papers, and opinions expressed in contributions are to be construed as those of the individual author rather than the official position of SIGART,the ACM, or any organization with which the writer may be affiliated. You are invited to join and participate actively. SIGART membership is open to ACM members upon payment of dues of $3.00 per year and to non-ACM members upon payment of dues of $5.00 per year. To indicate a change of address or to become a member of SIGART, complete the form on the last page of this issue.


Towards the Simulation of Clinical Cognition: Taking a Present Illness by Computer Program

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A YOUNG MAN, WHO HAS OLIGURIA. IT HAS BEEN DENIED THAT HE HAS RECENT SCARLET FEVER. HE HAS NOT-RECEIVED RADIOGRAPHIC CONTRAST MATERIAL. HE HAS NOT-RECEIVED NEPHROTOXIC DRUGS. HE HAS MODERATELY-ELEVATED URINE SODIUM.




A Model of Inexact Reasoning in Medicine

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Reprinted in Readings in Uncertain Reasoning, G. Shafer and J. Pearl, eds., pp. 259-273, San Mateo, CA: Morgan Kaufmann Publishers, Inc., 1990.See also: Stanford Center for Biomedical Informatics Research (BMIR).… quantifying confirmation and then manipulating the numbers as though they were probabilities quickly leads to apparent inconsistencies or paradoxes. Carl Hempel presented an early analysis of confirmation (Hempel, 1965), pointing out as we have that C[h,e] is a very different concept from P(hle ). His famous Paradox of the Ravens was presented early in his discussion of the logic of confirmation. Let hl be the statement that "all ravens are black" and h2 the statement that "all nonblack things are nonravens." Clearly hi is logically equivalent to h,2. If one were to draw an analogy with conditional probability, it might at first seem valid, therefore, to assert that C[hl,e] = C[h2,e] for all e. However, it appears counterintuitive to state that the observation of a green vase supports hi, even though the observation does seem to support h,2. C[h,e] is therefore different from P(hle) for it seems somehow wrong that an observation of a vase could logically support an assertion about ravens. Another characteristic of a quantitative approach to confirmation that distinguishes the concept from probability was well-recognized by Carnap (1950) and discussed by Barker (1957) and Harrd (1970). They note it is counterintuitive to suggest that the confirmation of the negation of a hypothesis is equal to one minus the confirmation of the hypothesis, i.e., C[h,e] is not 1 - C[-qh,e]. The streptococcal decision rule asserted that a gram-positive coccus growing in chains is a Streptococcus with a measure of support specified as 7 out of 10. This translates to C[h,e]=0.7 where h is "the organism is a Streptococcus" and e is the information that "the organism is a gram-positive coccus growing in chains." As discussed above, an expert does not necessarily believe that C[mh,e] = 0.3. The evidence is said to be supportive of the contention that the organism is a Streptococcus and can therefore hardly also support the contention that the organism is not a Streptococcus. Ch.13 of Mycin Book; revised from Math. Biosci. 23:351-379


Computer-based consultations in clinical therapeutics: Explanation and rule-acquisition capabilities of the MYCIN system

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Computers and Biomedical Research, 8 (4): 303-320. Reprinted in Sheehy, N. and Capman, A.J., eds. The International Library of Critical Writings in Psychology: Cognitive Science, London: Edward Elgar Publishing Ltd., pp. 250-267, 1995. See also: Stanford HPP 75-2.