Medical artificial intelligence and zoology motivation knowledge inscribe ③

Basic Medical Pathology: Neoplasis I

[medical artificial intelligence and problem of zoology motivation knowledge] : Actual medical intelligence demand

Software of medical of family approach force (Shenzhen) limited company Likewei

3, the backtrack of medical artificial intelligence

Regretful is, the plod that passes many top expert, spent much money, with the medical expert that is based on generation type regulation the department consolidates model, the medicine that is based on a knowledge base is decision-making the system also fails to be applied successfully likewise at clinical, what reason is this?

We know: Problem of play chess of rich of unlike of medical diagnosis and treatment in that way, solved the problem inside a chessboard to solve all problems. Medical treatment process has a lot of ‘ chessboard ‘ , there is echo of size nest, from beginning to end between them, repeat retroflexion wait for a variety of forms. ILIAD and QMR solved only ‘ chessboard ‘ problem, the dimensional range that uses actually and process limits are restricted, for example: If the person contracts many diseases have underlying concern, the intellectual system of ILIAD and QMR is lesser, cannot without exception the disease of complete person suffers from; Run a course without whole ill case, lack understands the mechanism of patient history; The system such as the lab that cannot swim with fluctuation, drug-store, nurse, statistic is coessential join, the semmetry that lacks information is passed on etc. This is island of a Gu, opposite at the person a variety of potential pain suffer from is island of a Gu, the photograph is complete to medical treatment the process is island of a Gu, also be island of a Gu to managing at the hospital. Gu island is inevitable and bedraggled.

Why American researcher not all ‘ chessboard ‘ do complete? One of reasons are: All like an ILIAD such software cost about 20 years of time, 20 million U.S. dollor, the budget of system of whole medical treatment is gotten possibly greatly breathtaking; Of the reason is: Advocate at ‘ numeric computation ‘ ‘ theorematic proof ‘ or ‘ feedback is controlled ‘ American, to conclusion cannot convergent, and the probability that has the history and culture character concludes the system is not special favour. Japan connected the commanding elevation that produces a province to be loot intelligence computer 1982, constituent Fuji is connected wait for 8 big well-known companies, bump into the tight encirclement of computer of the Five Dynasties directly with the imposing manner of extensive great. American is right outside this word besides beautiful excessive of not stint miserly, manage money namely wait-and-see. The Japanese after 10 years is defeated below blast come, large quantities of artificial intelligence companies also are in the whole world this one period closes down. Medical artificial intelligence also is and battle and retreat, from on 90 time metaphase begins the century enter cereal ground. The result is, come nearly 40 years medical expert system and decision-making support system, neither one can be thrown truly clinical and practical.

Medical artificial intelligence is not valued, medical bound does not have wait for windfalls, they are retreated and beg next, build the defense line after rising with electronic anamnesis. On January 20, 2004, bush‘s president is in send congress " national condition report " in announced a plan: Ensure henceforth American of the great majority inside 10 years has electronic health to record; British government the order of informatization of world the biggest medical treatment with 5.5 billion pound, with IT supplier the lot falls ‘ national Medical Protection serves a system ‘ contract; Management board of Hong Kong hospital also develops clinical information system to wait a moment with 1.6 billion HK dollar. These with great quantity the plan is not had is not to want to take next medical treatment whole process ‘ chessboard ‘ ; But look from a few more specific plan data, their exert oneself dot does not think from ‘ artificial intelligence ‘ the respect obtains a breakthrough, is to be in only ‘ general affairs is handled ‘ draw close to hi-tech on the level, with ‘ healthy record ‘ declare a government to regard as.

Actually, each country government offers a comprehensive electronic anamnesis plan very hard from technical level, rising first is by far-sighted business company clamour gives a kind of aura, draw close the large equipment that produces oneself toward IT, the purpose is to use hospital informatization to contact product equipment, create technical concept with commercial monopoly train of thought, be like: Integratingthe HealthcareEnterprise ‘ comprehensive medical treatment is compositive ‘ , large company nature acquires position of the leader of an alliance. We listen to the employee of German Xi Menzi to had told about this kind of strategy. The compositive program that American global company offers more become firm of Chinese numerous HIS of imitated, the ceremony of proclaiming sb a Buddhist ‘ ancestor model ‘ ; Electronic anamnesis EPR is by buy among this the core of construction of system.

The development orientaton that controls medicine by the technology does not have a mistake probably, by who the medical meaning that the problem is electronic anamnesis should be finished?

4, medical treatment record drives intelligence to change requirement

Any expression of medicine include lab data, OK perhaps must change to describe a language, because any judgement of medicine and conclusion must be participated in of the person directly, OK without a kind of any pure physics signal or digital information complete description person. Descriptive sex characteristic of medicine also makes medical meaning more rely on the medical treatment record that gives a patient, without a kind the record can be recorded like medical treatment get the connection such as Wu of person, learning, life, common, law, science in that way more close together. What so medical treatment records is multifarious also hold negative people‘s expectations in the palm, increasingly arduous rise.

Ancient Greek times had had medical record, content is the recount before coming on event that records patient or patient relative by time order and ailment process, this kind of style lasts to Industrial Revolution times all the time. 17 centuries suffer Darwinism and taxology effect, anamnesis began to have ‘ expression of a group of symptoms is equal at a disease ‘ thought; But the specific notes pattern of anamnesis or copy once upon a time. To 1880, the anamnesis in American Mayo clinic is to record the gathering account book in the doctor to go up; They built folder respectively to every patient 1907; Clinic asked the doctor records the basic data of a group of regulations in anamnesis 1920, include: Patient action in chief, clinical discovery, doctor is diagnosed, remedial plan, showed standardization trend.

The book of anamnesis writes a method is to press average order to write a habit inside a long time, the doctor encounters what to write, did not make clear classification, be called ‘ Composite running water records a law ‘ . 20 centuries 60 time, the case history that Dr.Lawrence Weed offerred POMR (Problem Oriented MedicalRecord) is formatted conception, there is list of a problem first in anamnesis namely, have the record of SOAP form to every problem next. Among them, s represents subjective element, namely the patient feeling to the disease; O represents objective element, namely the clinical discovery that cure protects personnel, include to check; A expresses to evaluate, namely the doctor‘s conclusion; P shows a plan, put forward to treat plan according to diagnosing conclusion namely or handle measure. SOAP structure established the fundamental form of contemporary case history. But, the time that POMR record law takes up cure protects personnel to write is too much, taiwan has a hospital to say in the evaluation when executing POMR to record a law: Keeping medical record is the most onerous job that cure protects personnel to must want to do everyday. Some earlier year in the United States arisen Focus Charting says ‘ the focus records a law ‘ ; Method of form type data is called Structural DataEntry namely ‘ structuralization records a law ‘ or SDE.

The history comes to a such doorsills eventually: The high strenth that is anamnesis above all records a problem to must be solved, it is the computer next ‘ general affairs is handled ‘ the times comes stealthily, it is Euramerican again the habit that records medical record with typewriter is already confirmed; 3 person mutual add fuel to the fire, collect synthetic west ‘ electronic anamnesis ‘ headstream.

What appear at first is law of electronic text record, ‘ electronic anamnesis ‘ the changeover that makes clear record tool only, the pattern that its record and target all were not changed. But, of the tool change to often have revolutionary quality, a few character that belong to a tool and function, if input, save, inquiry, call, share etc, advanced working way and even observation means to produce a change. Among them first job is to solve the intensity problem of the input, appeared to use form to handle the function of structured data later. A typical case: The RMIS of medical information system that 70 time develop the century on, it used form of a kind of go to a doctor: Its are right description of the action in chief that is a patient, medical history, use text to handle way, it is to be used first handwritten, input computer by person specially assigned for a task again; Its are left upper part is diagnostic list, the disease name that listed doctor diagnoses; Wrong lower part is structured data list, the record is important physiology parameter and examine parameter; RMIS returns somebody to use up to now. Some closer year SDE has electronic layout life, it develops the good point of form structure input method, not only the simple data that can process place of equipment of test for parallelism to arise with direct model, and the complex data that can have professional dependence with indirect model processing. The structured data of SDE originates dictionary, its intellectual editor can remove a standard to input lexical action. This kind of feature is a kind of progress of method of electronic anamnesis input, be in China, those who have Chinese distinguishing feature ‘ text pattern plate edits a law ‘ or ‘ of half structuralization pick a word to change sentence structure ‘ , showed medical treatment to record the current with the standardization confluent direction to medical artificial intelligence.

5, electronic anamnesis and knowledge base system

In front, we revealed two lines: Medical artificial intelligence was experienced from ‘ rich play chess is politic ‘ advance ‘ expert system ‘ , again hind remove ‘ decision-making support ‘ process; Medical treatment record was experienced ‘ mixture record law ‘ to ‘ POMR records a law ‘ , arrive next ‘ the structure records a law ‘ , arrive again ‘ electronic text records a law ‘ . The research on two lines end a variety of likelihoods, have not get perfecting developing, remain both photograph to combine a likelihood to take the way that open only finally. From medical artificial intelligence, what move toward conformity through the record pattern of electronic anamnesis is clinical apply; From electronic anamnesis, pass medicine artificial wisdom the means that technical measure obtains processing to be recorded in great quantities. The difficulty that only question is both union is too great, so, a lot of country passes balance, choose to pass ‘ electronic anamnesis ‘ obtain positive result, avoid to allude the hope is uncertain ‘ medical artificial intelligence ‘ .

Electronic anamnesis can face the problem of data standardization forever, decision-making system accords with knowledge this one requirement. ‘ dictionary ‘ the standardization that is data assembles, its method is logarithm handle according to undertaking standardization and structuralization. The length that standardization and structuralization are the computer, the development workload of foreign electron anamnesis basically also is expended go up in structured problem. Pass old practice to prove later: Will narrate sexual information to undertake structuralization uses special difficulty, doctors ask for the expression that wait to semiotic body difference is too big, the time that before terminal data-in expends is too much also. Before these problems were not bringing choose and employ persons to be versed in intelligence is solved, the development of anamnesis of electron of inevitable block up, electronic anamnesis can pick a word to change along electronic text only sentence ground of old road blindly follow sb goes downward. Inside China‘s quite long period of time, the job of structuralization of medical treatment data is replaced by simpler way, that does an input to operate far from namely, call an off-the-peg text directly appropriative anamnesis, revise simply next, make electronic medical record.

Electronic anamnesis must be based on traditional case history ask and exist, ability is unapt the medical purpose that loses it. The main task of anamnesis is a record, the formation of anamnesis is come from at seeing a doctor. ‘ see a doctor ‘ it is the record that doctor and patient produce interactively, include thinking and thinking to carry out a process. Specific say: ‘ see a doctor ‘ process besides the interrogation record, record that examine system, auxiliary servy record, still include: Spark think, analysis the integrated, feedback after obtaining instruction of conclusion, definite plan, make known to lower levels, executive injunction, reflection that causes again by feedback, by think bring about the statement with new make known to lower levels to wait, form feedback thinking loop. Very apparent, the problem of electronic anamnesis cannot get through the development of oneself satisfactory solve, must get on what electronic anamnesis puts it the likelihood solves an ability in the system, and on the system must apply artificial intelligence technology to just may be perfected.

Be in nest of electronic anamnesis system medical knowledge is decision-making in the system; Again knowledge decision-making system nest changes digital hospital system in integral intelligence in, medical treatment is decision-making with medical treatment record frit is one furnace, finish itself of whole to the patient‘s medical treatment process already, complete the part that medical treatment process acts as in the hospital again. Specific train of thought is: Doctor application is based on the intelligence of the knowledge base to change platform of diagnosis and treatment to see a doctor for the patient, the contrail that the doctor sees a doctor by self-recording come down, make electronic medical record. The technical procedure that forms electronic anamnesis is very simple, the content hang on of electronic anamnesis ‘ knowledge base ‘ ; Of artificial intelligence see a doctor the model is very simple, namely ‘ computer ＋ knowledge base ‘ , the technical difficulty impute to that turns intelligence ‘ knowledge is conveyed ‘ .

(unfinished to be continued)