Download PDF
Methods Inf Med 1990; 29(02): 122-131
DOI: 10.1055/s-0038-1634774
Knowledge-based systems
Schattauer GmbH

DYNASCENE: An Approach to Computer-Based Intelligent Cardiovascular Monitoring Using Sequential Clinical “Scenes”

A. I. Cohnl
,
S. Rosenbauml
2   Department of Internal Medicine, Yale University School of Medicine, Yale University, New Haven, USA
,
M. Factor
3   Department of Computer Science, Yale University, New Haven, USA
,
P. L. Millerl
› Author AffiliationsThis research is supported in part by NIH grants T1S LM070S6 and R01 LM04336 from the National Library of Medicine and by a grant from the Ira DeCamp Foundation. The authors would like to thank Jeffrey Clyman, M. D. who provided a valuable review of an early draft of this manuscript, and Dean F. Sittig, Ph. D. who helped prepare data for DYNASCENE testing. This paper is an extended version of a paper presented at the Thirteenth Annual Symposium on Computer Applications in Medical Care (SCAMC XIII, Washington, D. C), published with permission.
Further Information

Publication History

Publication Date:
06 February 2018 (online)

    Permissions and Reprints

Abstract

Hemodynamic abnormalities such as hypovolemia typically progress through a sequence of discrete clinical phases or “scenes” (e. g., intravascular volume depletion, vasoconstriction, hypotension). Each scene can be defined by a cluster of hemodynamic trends. A natural approach to modeling the process of hemodynamic monitoring involves identifying these scenes and the temporal relationships among them. This approach has been utilized in the development of DYNASCENE, a parallel programming implementation of a computer-based intelligent hemodynamic monitor. This paper discusses: (1) The rationale for utilizing sequential clinical scenes to represent knowledge of hemodynamic behavior, (2) the design of the DYNASCENE system, and (3) preliminary tests of the DYNASCENE system.

Key-Words

Expert Systems - Computer-Assisted Diagnosis - Knowledge Representation - Real-Time Systems
 

  • REFERENCES

  • 1 Gelernter D. Generative communication in Linda. ACM Trans Prog Lang Sys 1985; 07: 80-112.
    CrossrefPubMedSearch in Google Scholar
  • 2 Carriero N, Gelernter D. Applications experience with Linda. In: Proceedings of the ACMISIGPLAN PPEALS (Parallel Programming: Experience with Applications, Languages and Systems) Conference. New Haven CT: 1988: 173-87.
    Search in Google Scholar
  • 3 Miller PL, Factor M, Gelernter D, Sittig DF, Cohn AI, Rosenbaum S. A Parallel Process Lattice Model for an Intelligent Cardiovascular Monitor. In: Proceedings of AAMSI Congress 89. Washington DC: American Association for Medical Systems and Informatics; 1989: 121-5.
    Search in Google Scholar
  • 4 Mc Call D, Badke F, O’Rourke RA. Congestive Heart Failure. In: Stein JH. ed. Internal Medicine. Boston Mass: Little and Brown; 1987: 398-405.
    Search in Google Scholar
  • 5 Parker RC, Miller RA. Using Causal Knowledge to Create Simulated Patient Cases: The CPCS Project as an Extension of INTERNIST-I. In: Stead WW. ed. Proceedings of the 11th Symposium on Computer Applications in Medical Care. New York NY: IEEE Press; 1987: 473-80.
    Search in Google Scholar
  • 6 Fagan LM, Kunz IC, Feigenbaum EA, Osborn JJ. Extensions to the rule-based formalism for a monitoring task. In: Buchanan BG, Shortliffe EH. eds. Rule Based Expert Systems. Reading, Mass: Addison-Wesley; 1984: 397-423.
    Search in Google Scholar
  • 7 Fagan LM, Shortliffe EH, Buchanan BG. Computer-based medical decision making: from MYCIN to VM. In: Clancey WI, Shortliffe EH. eds: Readings in Medical Artificial Intelligence. Reading, Mass: Addison- Wesley Publishing Company; 1984: 241-55.
    Search in Google Scholar
  • 8 Long WI, Naimi S, CriscitieIIo MG. et al. The development and use of a causal model for reasoning about heart failure. In: Stead WW. ed. Proceedings of the 11th Symposium on Computer Applications in Medical Care. New York NY: IEEE Press; 1987: 30-6.
    Search in Google Scholar
  • 9 Schank RC, Riesbeck CK. Inside Computer Understanding, Five Programs Plus Miniatures. Hillsdale NI: Lawrence Erlbaum Associates; 1981
    Search in Google Scholar
  • 10 Schank RC, Riesbeck CK. Scripts, Plans, Goals and Understanding. Hillsdale NI: Lawrence Eribaum Associates; 1977
    Search in Google Scholar
  • 11 Fisher PR, Miller PL, Swett HA. Script formalism as a knowledge representation for medical expert systems: Modeling multiple perspectives. In: Proceedings of the AAAI Spring Symposium Series: Artificial Intelligence in Medicine. Menlo Park CA: AAAI; 1988: 25-6.
    Search in Google Scholar
  • 12 Fisher PR, Miller PL, Swett HA. Great expectations: Expectation based reasoning in medical diagnosis. In: Greenes RA. ed. Proceedings of the 12th Symposium on Computer Applications in Medical Care. New York NY: IEEE Press; 1988: 38-42.
    Search in Google Scholar