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Methods Inf Med 1985; 24(04): 181-191
DOI: 10.1055/s-0038-1635377
Original Article
Schattauer GmbH

The Impact of an Explanation Capability for a Computer Consultation System

Die Bedeutung der Fähigkeit zur Kommentierung für ein Computerberatungssystem
H. P. Erdman
1   (From the Psychiatric Computing Laboratory, Department of Psychiatry, University of Wisconsin, Madison, USA)
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Publication History

Publication Date:
17 February 2018 (online)

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Abstract

The impact of a computer consultation program including explanations for its decisions was examined. The consultation program was designed as a decision aid for non-psychiatrists regarding the treatment of depression. Both psychiatrists and non-psychiatrists were used to evaluate the system, with different results for the two groups. Explanations improved the non-psychiatrists’ attitudes towards the computer recommendations, while for psychiatrists the impact of explanation depended on the specific content of the recommendations and explanations. The results for psychiatrists were consistent with the view that explanations are important for computer consultation systems because they may help physicians decide whether or not the computer’s advice is reasonable.

Die Bedeutung eines Computerberatungsprogramms mit Erklärungen für seine Entscheidungen wurde untersucht. Das Konsultationsprogramm wurde als Entscheidurigshilfe für Nicht-psychiater bei der Behandlung von Depressionen erarbeitet. Sowohl Psychiater als auch Nichtpsychiater werteten das System aus – mit unterschiedlichen Ergebnissen in beiden Gruppen.

Erklärungen verbesserten die Einstellung der Nichtpsychiater gegenüber den Computerempfehlungen, während bei den Psychiatern das Gewicht des Kommentares von dem spezifischen Inhalt der Empfehlungen und Erklärungen abhängig war. Die Ergebnisse bei den Psychiatern bestätigten die Ansicht, daß Erklärungen von Bedeutung für Computerberatungssysteme sind, weil sie den Ärzten die Entscheidung darüber, ob der Rat des Computers vernünftig ist oder nicht, erleichtern können.

Key-Words:

Computer Consultation Systems - Expert Systems - Explanation - Medical Decision Making

Schlüssel-Wörter:

Computerberatungssysteme - Expertensysteme - Erklärung - ärztliche Entscheidungsfindung
 

  • REFERENCES

  • 1 Bar-Hillel Y. Is information retrieval approaching a crisis? Amer. Doc 1963; 14: 95-97.
    PubMedSearch in Google Scholar
  • 2 Bleich H. L. Computer evaluation of acid-base disorders. J clin. Invest 1969; 48: 1689-1696.
    CrossrefPubMedSearch in Google Scholar
  • 3 Cohen J. Weighted kappa: nominal scale agreement with provision for scaled disagreement or partial credit. Psychol. Bull 1968; 70: 213-220.
    CrossrefPubMedSearch in Google Scholar
  • 4 Cronbach L. J. Coefficient alpha and the internal structure of tests. Psychometrika 1951; 16: 297-334.
    CrossrefPubMedSearch in Google Scholar
  • 5 D’Arcy C. Patterns in the delivery of psychiatric care in Saskatchewan 1971-1972 An overview of service sectors and patient volumes. Can. Psychiatr. Ass. J 1976; 21: 91
    PubMedSearch in Google Scholar
  • 6 Dannenberg A. L, Shapiro A. R, Fries J. F. Enhancement of clinical predictive ability by computer consultation. Meth. Inform. Med 1979; 18: 10-14.
    PubMedSearch in Google Scholar
  • 7 De Dombal F. T, Leaper D. J, Horrocks J. C, Staniland J. R, McCann A. P. Human and computer-aided diagnosis of abdominal pain: further report with emphasis on performance of clinicians. Brit. med. J 1974; I: 376-380.
    PubMedSearch in Google Scholar
  • 8 Einhorn H. J, Hogarth R. M. Confidence in judgment: persistence of the illusion of validity. Psychol. Rev 1978; 28: 395-416.
    PubMedSearch in Google Scholar
  • 9 Erdman H. P, Greist J. H, Klein M. H, Jefferson J. W, Olson W, Salinger R. Computer Consultation for Psychiatric Diagnosis. In O’Neill J. F. (Edit.) The Fourth Annual Symposium on Computer Applications in Medical Care. New York: IEEE; 1980
    Search in Google Scholar
  • 10 Fischhoff B. Hindsight Φ foresight: the effect of outcome knowledge on judgment under uncertainty. J. exper. Psychol 1975; 3: 288-299.
    PubMedSearch in Google Scholar
  • 11 Fox J, Bardhan K. D, Barber D. C. Alternatives to Bayes? A quantitative comparison with rule-based diagnostic inference. Meth. Inform. Med 1980; 19: 210-215.
    PubMedSearch in Google Scholar
  • 12 Fryback D. G, Erdman H. Prospects for calibration of physicians’ probabilistic judgments: Design of a feedback system Proceed. IEEE Internat. Conf. on Cybernetics and Society. New York: IEEE; 1979: 340-345 .
    Search in Google Scholar
  • 13 Fryback D. G, Thornbury J. R. Evaluation of a computerized Bayesian model for diagnosis of renal cyst vs tumor vs. normal variant from excretory urogram information. Invest. Radiol 1976; 11: 102-111.
    PubMedSearch in Google Scholar
  • 14 Gillis J. S, Lipkin J. O, Moran T. J. Drug therapy decisions: a social judgment analysis. J. nerv. ment. Dis 1981; 169: 439-447.
    CrossrefPubMedSearch in Google Scholar
  • 15 Goldberg L. R. Man versus model of man: A rationale, plus some evidence, for a method of improving on clinical inferences. Psychol. Bull 1970; 73: 422-432.
    CrossrefPubMedSearch in Google Scholar
  • 16 Goldman L, Weinberg M, Weisberg M, Olshen R, Cook E. E, Sargent R. K, Lamas G. A, Dennis C, Wilson C, Deckelbaum L, Fineberg H, Stiratelli R. A computer derived protocol to aid in the diagnosis of emergency room patients with acute chest pain. New Engl. J. Med 1982; 307: 588-596.
    CrossrefPubMedSearch in Google Scholar
  • 17 Gorry G. A. Computer-assisted clinical decision making. Meth. Inform. Med 1973; 12: 45-51.
    PubMedSearch in Google Scholar
  • 18 Gustafson D. H, Greist J. H, Stauss F. F, Erdman H. P, Laughren T. P. A probabilistic system for identifying suicide attempters. Comput. biomed. Res 1977; 10: 83-89.
    CrossrefPubMedSearch in Google Scholar
  • 19 Gustafson D. H, Kestly J. J, Greist J. H, Jensen N. M. Initial evaluation of a subjective Bayesian Diagnostic System. Health Serv. Res 1971; 6: 204-213.
    PubMedSearch in Google Scholar
  • 20 Hoeper E. W, Nycz G. R, Cleary P. D, Regier D. A, Goldberg I. G. Estimated prevalence of RDC mental disorder in primary medical care. Int. J. ment. Hlth 1980; 8: 6-15.
    PubMedSearch in Google Scholar
  • 21 Landis J. R, Koch G. G. The measurement of observer agreement for categorical data. Biometrics 1977; 33: 159-174.
    CrossrefPubMedSearch in Google Scholar
  • 22 Levin J. R, Marascuilo L. A. Type IV errors and interactions. Psychol. Bull 1972; 78: 368-374.
    CrossrefPubMedSearch in Google Scholar
  • 23 Lichtenstein S, Fischhoff B. Do those who know more also know more about what they know? Organizat. Behav. Human Perform 1977; 20: 159-183.
    PubMedSearch in Google Scholar
  • 24 McDonald C. J. Protocol-based computer reminders, the quality of care and the non-perfectibility of man. New Engl. J. Med 1976; 295: 1351-1355.
    CrossrefPubMedSearch in Google Scholar
  • 25 Mesel E, Wirtschafter D. D, Carpenter J. T, Durant J. R, Henke C, Gray E. A. Clinical algorithms for cancer chemotherapy – systems for community-based consultant – extenders and oncology centers. Meth. Inform. Med 1976; 15: 168-173.
    PubMedSearch in Google Scholar
  • 26 Miller R. A, Pople H. E, Myers J. D. Internist-I, an experimental computer-based diagnostic consultant for general internal medicine. New Engl. J. Med 1982; 307: 468-476.
    CrossrefPubMedSearch in Google Scholar
  • 27 Mumford E. On being a patient. In Simons R. C, Pardes H. (Eds) Understanding Human Behavior in Health and Illness. Baltimore: Williams and Williams; 1981
    Search in Google Scholar
  • 28 Nielsen A. C, Williams T. A. Depression in ambulatory medical patients. Arch. gen. Psychiat 1980; 37: 999-1004.
    CrossrefPubMedSearch in Google Scholar
  • 29 Pople H. E, Myers J. D, Miller R. A. DIALOG: A model of diagnostic logic for internal medicine Proceed. Fourth Internat. Joint Conf. Artif. Intell. Cambridge/Mass: MIT Art. Intell. Lab. Publ; 1975: 848-855.
    Search in Google Scholar
  • 30 Raju N. S. Note on two generalizations of coefficient alpha. Psychometrika 1979; 44: 347-349.
    CrossrefPubMedSearch in Google Scholar
  • 31 Regier D. A, Goldberg I. D, Taube C. A. The de facto US mental health services system. Arch. gen. Psychiat 1978; 35: 685-693.
    CrossrefPubMedSearch in Google Scholar
  • 32 Shortliffe E. H, Axline S. G, Buchanan B. G, Cohen S. N. Design considerations for a program to provide consultation in clinical therapeutics. Proceed. San Diego biomed. Symp 1974; 13: 311-319.
    PubMedSearch in Google Scholar
  • 33 Shortliffe E. H, Buchanan B. G, Feigenbaum E. A. Knowledge engineering for medical decision making: A review of computer-based clinical decision aids. Proceed. IEEE 1979; 67: 1207-1224.
    CrossrefPubMedSearch in Google Scholar
  • 34 Shortliffe E. H, Davis R, Axline S. G, Buchanan B. G, Green C. C, Cohen S. N. Computer-based consultations in clinical therapeutics: Explanation and rule acquisition capabilities of the MYCIN system. Comput. biomed. Res 1975; 8: 303-320.
    CrossrefPubMedSearch in Google Scholar
  • 35 Spitzer R. L, Endicott J, Cohen J, Fleiss J. L. Constraints on the validity of computer diagnosis. Arch. gen. Psychiat 1974; 31: 197-203.
    CrossrefPubMedSearch in Google Scholar
  • 36 Swartout W. R. Explaining and justifying expert consulting programs. Proceed. Seventh Internat. Joint Conf. Artif. In-tell. Cambridge/Mass: MIT Art. Intell. Lab. Publ; 1981: S15-S22.
    Search in Google Scholar
  • 37 Taylor T. R, Aitchison J, McGirr E. M. Doctors as decision makers: A computer-assisted study of diagnosis as a cognitive skill. Brit. med. J 1971; III: 35-40.
    PubMedSearch in Google Scholar
  • 38 Teach R. L, Shortliffe E. H. An analysis of physician attitudes regarding computer-based clinical consultation systems. Comput. biomed. Res 1981; 14: 542-558.
    CrossrefPubMedSearch in Google Scholar
  • 39 Tversky A, Kahneman D. Judgment under uncertainty: heuristics and biases. Science 1974; 185: 1124-1131.
    CrossrefPubMedSearch in Google Scholar
  • 40 Wallis J. W, Shortliffe E. H. Explanatory power for medical expert systems: studies in the representation of causal relationships for clinical consultation. Meth. Inform. Med 1982; 21: 127-136.
    PubMedSearch in Google Scholar
  • 41 Wardle A, Wardle L. Computer-aided diagnosis. Meth. Inform. Med 1978; 17: 15-28.
    PubMedSearch in Google Scholar
  • 42 Warner H. R, Olmsted C. M, Rutherford B. D. HELP – A program for medical decision-making. Comput. biomed. Res 1972; 5: 65-74.
    CrossrefPubMedSearch in Google Scholar
  • 43 Weiner J. L. BLAH, a system which explains its reasoning. Artif. Intell 1980; 15: 19-48.
    CrossrefPubMedSearch in Google Scholar
  • 44 Weiss S. M, Kulikowski C. A, Amarel S, Safir A. A model-based method for computer-aided medical decision making. Artif. Intell 1978; 11: 145-172.
    CrossrefPubMedSearch in Google Scholar
  • 45 Weiss S. M, Kulikowski C. A, Safir A. Glaucoma consultation by computer. Comput. biol. Med 1978; 5: 25-40.
    PubMedSearch in Google Scholar
  • 46 Weissman M. M, Myers J. K, Thompson D. Depression and its treatment in a US urban community -1975-1976 Arch. gen. Psychiat 1981; 38: 417-421.
    PubMedSearch in Google Scholar
  • 47 Whitbeck C, Brooks R. Criteria for evaluating a computer aid to clinical reasoning. J. Med. Philos 1983; 8: 51-65.
    CrossrefPubMedSearch in Google Scholar
  • 48 Winer B. J. Statistical principles in experimental design. New York: McGraw-Hill; 1971
    Search in Google Scholar
  • 49 Yu V. L, Fagan L. M, Wraith S. M, Clancey W. J, Scott A. C, Hannigan J, Blum R. L, Buchanan B. G, Cohen S. N. Antimicrobial selection by computer: A blinded evaluation by infectious disease experts. J. Amer. med. Ass 1979; 242: 1279-1282.
    CrossrefPubMedSearch in Google Scholar