AI/LEARN: an interactive videodisk system for teaching medical concepts and reasoning

Structured computer-based training in the interpretation of neuroradiological images

Computer-based systems may be able to address a recognised need throughout the medical profession for a more structured approach to training. We describe a combined training system for neuroradiology, the MR Tutor that differs from previous approaches to computer-assisted training in radiology in that it provides case-based tuition whereby the system and user communicate in terms of a well-founded Image Description Language. The system implements a novel method of visualisation and interaction with a library of fully described cases utilising statistical models of similarity, typicality and disease categorisation of cases. We describe the rationale, knowledge representation and design of the system, and provide a formative evaluation of its usability and effectiveness.

Voting and priorities in health care decision making, portrayed through a group decision support system, using analytic hierarchy process

Within the health care industry many decision making approaches and tools are used. This paper explores a new tool, the Analytic Hierarchy Process (AHP), which permits both subjective and objective information to be considered in a decision. AHP has tremendous potential to solve both traditional and non-traditional health care problems. Its strength as a decision-making tool is its ability to combine both subjective and objective data. Application of AHP is discussed within the context of a Group Decision Support System (GDSS) model developed by Hatcher. The model is reviewed in limited detail, and readers are referred to the original article that defined and discussed the uniqueness and level of sophistication of GDSS applications in the health care industry. Health and medical delivery problems are discussed to highlight AHP requirements and the complexity of AHP applications. Health care applications are unique in that they lend themselves ideally to the use of computer data, image, voice, text, and multimedia concepts.

GALE: a graphics assisted learning environment for computer-based interactive videodisc education

GALE, a Graphics Assisted Learning Environment, is a computer-based interactive videodisc authoring tool. GALE was created as the authoring package for AI/LEARN/Rheumatology, an independent study system for teaching rheumatology to medical trainees. GALE has potential widespread application beyond rheumatology. Interactive videodisc technology is a prime feature of GALE. Other highlights are: WordPerfect macros which simplify programming, graphics-based large text characters, tracking of user responses, hypertext-like definition capabilities, color coded screens to distinguish between hypertext branches and the mainstream of the course content and ability to overlay text on the video image. GALE runs on a PC-compatible computer with selected Pioneer LaserDisc players. GALE uses WordPerfect 5.1 for text editing and has been designed for use by non-programmers.

Design and implementation of a microcomputer-based tutorial in radiation oncology

The design and implementation of a computer-based training system for radiation oncology was undertaken. A frame-based system was chosen, with factual information from Principles and Practices of Radiation Oncology, by Perez and Brady, as the body of knowledge. Each unit of the system was based on a site (chapter) and consists of three sections: text, review questions, and patient management problems. The text section contains text, tables, and references and defines the information upon which the review questions and clinical cases are based. The review questions are multiple choice and true-false, and immediate feedback is given for both correct and incorrect responses. The patient management problems are interactive and provide alternative methods of presenting information and stimulating problem-oriented thought. The emphasis in all sections is on learning rather than testing. Advantages of a computer-based tutorial include the ability to present large volumes of information easily, the capacity for immediate feedback, and the flexibility of format in presentation of material. Potential applications are discussed.

Uniqueness of Group Decision Support Systems (GDSS) in medical and health applications

Group Decision Support Systems (GDSS) are defined and discussed. A GDSS model developed by the author is reviewed in depth for communication of the concepts of GDSS. The model's components are related to health care applications. Questions about unique requirements and level of sophistication in health care applications are explored. What are the differences? What is needed in GDSS software? How do implementation strategies differ? The purpose of this paper is to define and discuss the uniqueness and level of sophistication of GDSS applications in health care. The information requirements and level of information abstraction are the major forces considered in the design of specific medical GDSSs. Data for the GDSS and queries originate both internally and externally to the system. Raw data may be in image form and require extensive analysis by the decision makers for information to be extracted from the raw data. Efforts also are made to relate financial and medical data for better business decisions. This integration often has limited success. Additionally, financial data represent multiple sources and present concerns of validity and reliability. In medical diagnoses the knowledge bases are large and contain thousands of rules. Treatment planning and progress reporting rely on medical records that contain thousands of information items and that often require interpretation by an expert. These information attributes go beyond qualitative versus quantitative definitions and are the author's basis for the analysis presented in this paper.

Use of interactive videodisc for teaching of pathology laboratory cases

Images from a generic videodisc called the 'Slice of Life' were utilized to develop computer-assisted interactive videodisc instruction (IVI) units for supplemental independent review of the laboratory cases studied in the general pathology course for year 1 medical students. Four units based on laboratory cases (two on 'inflammation' and two on 'neoplasia') were developed for a dual-screen Macintosh system. With this dual-screen system, specific picture frames from the videodisc could be retrieved on one screen while the other screen displayed the corresponding text. Each unit contained a number of case studies, each of which consisted of a clinical profile, gross picture and description of the tissue removed, sequential photomicrographs at successively higher magnifications from various fields of slides and their descriptions, comparison with the normal histology of the organ involved, interpretation of the observations and comments, final diagnosis, and a quiz at the end. Histopathological features were specifically emphasized. Evaluation of the units obtained from three consecutive classes of students indicated that these units were received as valuable supplemental tools for independent review of the laboratory cases.

AI/LEARN network. The use of computer-generated graphics to augment the educational utility of a knowledge-based diagnostic system (AI/RHEUM)

AI/LEARN Network is an educational package that enhances a knowledge-based diagnostic system called AI/RHEUM. This paper describes a microcomputer-based graphical representation of the knowledge base and discusses graphical representation of knowledge.