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Medical Decision Making
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An Architecture for Knowledge-based Construction of Decision Models

Frank A. Sonnenberg, MD

C. Greg Hagerty, BS

Casimir A. Kulikowski, PhD

Clinical application of decision analysis has been limited by unfamiliarity of clinicians with the technique, large data requirements, and the length of time needed to construct models. In order to make decision modeling more accessible to clinicians, the authors developed a computer program to construct decision models automatically. The system contains two separate knowledge bases. One contains frames encoding knowledge of the medical domain, the evaluation of pulmonary disease in patients infected with the human immunodeficiency virus (HIV). The other contains rules of correct decision model construction that guide the selection of items from the domain knowledge base and their insertion into the decision model. The system can create either a tree or an influence diagram that satisfies previously published critiquing rules. The system has the potential to enable novices to construct useful decision models and to provide individualized decision-analytic advice to clinicians in real time. Key words: intelligent decision system; knowledge-based model construction; decision trees; influence diagrams; Bayesian belief nets. (Med Decis Making 1994;14:27-39)

Medical Decision Making, Vol. 14, No. 1, 27-39 (1994)
DOI: 10.1177/0272989X9401400104
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