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Yearb Med Inform 2010; 19(01): 121-136
DOI: 10.1055/s-0038-1638702
DOI: 10.1055/s-0038-1638702
Original Article
A History of the INTERNIST-1 and Quick Medical Reference (QMR) Computer-Assisted Diagnosis Projects, with Lessons Learned
Further Information
Correspondence to:
Randolph A. Miller, MD
Donald A.B. and Mary M. Lindberg University Professor
Department of Biomedical Informatics
Vanderbilt University Medical Center Room B003C Eskind Biomedical Library 2209 Garland Avenue
Nashville, TN 37232-8340
Publication History
Publication Date:
07 March 2018 (online)
Summary
The INTERNIST-1/Quick Medical Reference (QMR) diagnostic decision support project spans four decades, from 1971-onward. This paper describes the history of the project and details insights gained of relevance to the general clinical and informatics communities.
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References
- 1 Collen MF. A History of Medical Informatics in the United States: 1950 to 1990. Bethesda, MD: Amer Med Informatics Assoc; 1995: 489 pages. ISBN 0-9647743-0-5..
- 2 Miller RA. Medical diagnostic decision support systems: past, present, and future. J Am Med Inform Assoc 1994; 01: 827.
- 3 Miller RA. Computer-assisted diagnostic decision support: history, challenges, and possible paths forward. Adv Health Sci Educ Theory Pract 2009; Sep; 14 Suppl (Suppl. 01) 89-106 Epub 2009 Aug 12. PMID: 19672686..
- 4 Pople HE, Myers JD, Miller RA. DIALOG:A model of diagnostic logic for internal medicine. In: Proc Fourth Internat Joint Conf Artif Intel. Cambridge, Massachusetts: MIT Artificial Intelligence Laboratory Publications. 1975: 848-55.
- 5 Miller RA, Schaffner KF. The logic of problemsolving in clinical diagnosis: a course for secondyear medical students. J Med Ed 1982; 57: 63-5.
- 6 Miller RA, Pople Jr HE, Myers JD. INTERNIST-1, An Experimental Computer-based Diagnostic Consultant for General Internal Medicine. N Engl J Med 1982; 307: 468-76.
- 7 Pople Jr HE. Heuristic methods for imposing structure on ill-structured problems: the structuring of medical diagnostics. In Szolovits P. (ed): Artificial Press; (AAAS Symposium Series, no. 51). 1982: 119-190.
- 8 Miller RA. Diagnostic and Prognostic Decision making Systems:A Survey of Recent Developments in the United States. In: Koehler CO, Tautu P, Wagner G. editors. Der Beitrag der Informationsver- arbeitung zum Fortschritt der Medizin. Medizinische Informatik und Statistic series, #50. Proceedings of the 28th Jahrestagung, Deutsche Gesellschaft fur Medizinische Dokumentation, Informatik und Statistik. Heidelberg, Germany: Springer Verlag; 1983
- 9 Miller RA. INTERNIST-1/CADUCEUS: Problems Facing Expert Consultant Programs. Methods Inf Med 1984; 23: 9-14.
- 10 Miller RA. A Computer-based Patient Case Simulator. Clin Res 1984; 32: 651A.
- 11 First MB, Soffer LJ, Miller RA. QUICK (QUick Index to Caduceus Knowledge): Using the INTERNIST-1/CADUCEUS Knowledge Base As An ElectronicTextbook of Medicine. Comp Biomed Res 1985; Apr; 18 (02) 137-65.
- 12 Miller RA, Schaffner KF, Meisel A. Ethical and Legal Issues Related to the Use of Computer Programs in Clinical Medicine. Ann Intern Med 1985; 102: 529-36.
- 13 Miller RA. INTERNIST-1, An Experimental Program for Consultation in General Internal Medicine: A Critical Review of its Approach to the Use of Laboratory Information for Diagnosis. In: Proc 32nd Meeting Japan Soc Clin Path. Matsumoto, Japan; September, 1985
- 14 Masarie Jr FE, Miller RA, Myers JD. INTERNIST-1 PROPERTIES:RepresentingCommonSenseandGood MedicalPracticeinaComputerizedMedicalKnowledge Base. Comp Biomed Res 1985; 18: 458-79.
- 15 Miller RA, Masarie Jr FE, Myers JD. “Quick Medical Reference” for diagnostic assistance. MD Computing 1986; 03: 34-48.
- 16 Heckerman D, Miller RA. Towards a better understanding of the INTERNIST-1 knowledge base. In: Salamon R, Blum B, Jorgenson M. editors. Proc MEDINFO 86. Washington, D.C: 1986: 22-6.
- 17 Miller RA, McNeil MA, Challinor S, Masarie Jr FE, Myers JD. Status Report: The INTERNIST-1 / Quick Medical Reference Project. West J Med 1986; 145: 816-22.
- 18 Miller RA. Computer based Diagnostic Decision making. Medical Care 1987; 25 (12) S148-S152.
- 19 Bankowitz RA, Blumenfeld BH, Miller RA. User variability in Abstracting and entering printed case histories with Quick Medical Reference (QMR). Proc 11th Annu Symp Comput Appl Med Care. Washington, DC: IEEE Press; 1987: 68-73.
- 20 Parker RC, Miller RA. Using causal knowledge to create simulated patient cases: The CPCS project as an extension of INTERNIST 1. Proc 11th Annu Symp Comput Appl Med Care. Washington, DC: IEEE Press; 1987: 473-80.
- 21 Lincoln M, Turner C, Hesse B, Miller RA. A comparison of Clustered Knowledge Structures in Iliad and in Quick Medical Reference. Proc 12th Annu Symp Comput Appl Med Care. Washington, DC: IEEE Press; 1988: 131-5.
- 22 Giuse NB, Giuse DA, Miller RA. Computer assisted multi-center creation of medical knowledge Care. Washington, DC: IEEE Press; 1988: 583-90.
- 23 Giuse NB, Bankowitz RA, Giuse DA, Parker RC, Miller RA. Medical Knowledge Base Acquisition: The Role of the Expert Review Process in Disease Profile Construction. Proc 13th Annu Symp Comput Appl Med Care 1989; 105-9.
- 24 Wagner MM, Bankowitz RA, McNeil MA, Challinor SM, Janosky JE, Miller RA. The diagnostic importance of the history and physical examination as determined by the use of a medical decision support system. Proc 13th Annu Symp Comput Appl Med Care 1989; 139-44.
- 25 Bankowitz RA, McNeil MA, Challinor SM, Parker RC, Kapoor WN, Miller RA. A computerassisted medical diagnostic consultation service: implementation and prospective evaluation of a prototype. Ann Intern Med 1989; 110: 824-32.
- 26 Miller RA, Masarie Jr FE. Use of the Quick Medical Reference (QMR) program as a tool for medical education. Methods Inf Med 1989; 28: 340-5.
- 27 Parker RC, Miller RA. Creation of a knowledge base adequateforsimulatingpatientcases:addingdeepknowledge to the INTERNIST-1/QMR Knowledge Base. Methods Inf Med 1989; 28: 346-51.
- 28 Bankowitz RB, McNeil MA, Challinor SM, Miller RA. Effect of a computer-assisted general medicine diagnostic consultation service on house staffdiagnosticstrategy. Methods Inf Med 1989; 28: 352-6.
- 29 Giuse NB, Giuse DA, Miller RA. Medical knowledge base construction as a means of introducing students to medical informatics. Proc Internat Symp Med Informat Educ. IMIA:Victoria, BC May 1989; 228-32.
- 30 Miller RA, Masarie Jr FE. The demise of the “Greek Oracle” model for medical diagnostic systems. Methods Inf Med 1990; 29: 1-2.
- 31 Miller RA. Why the standard view is standard: people, not machines, understand patients’ problems. J Med Philos 1990; 15: 581-91.
- 32 Giuse DA, Giuse NB, Miller RA. Towards computer assisted maintenance of medical knowledge bases. Artif Intel Med 1990; 02: 21-33.
- 33 Mabry ME, Miller RA. Distinguishing drug toxicity syndromes from medical diseases: a QMR computer-based approach. Proc 14th Annu Symp Comput Appl Med Care. Washington, DC:IEEE Computer Society Press 1990; 65-71.
- 34 Miller RA, Giuse NB. The medicine in medical informatics: medical knowledge bases. Acad Med 1991; 66 (01) 15-7.
- 35 Giuse DA, Giuse NB, Bankowitz RA, Miller RA. Heuristic determination of quantitative data for knowledge acquisition in medicine. Comput Biomed Res 1991; 24 (03) 261-72.
- 36 Shiffman S, Wu AW, Poon AD, Lane CD, Middleton B, Miller RA. et al. Building as peechinter facetoamedical diagnostic system. IEEE Expert 1991; 06: 41-50.
- 37 Bankowitz RA, Miller JK, Janosky J. A prospective analysis of inter-rater agreement between a physician and a physician’s assistant in selecting QMR vocabulary terms. Proc Annu Symp Comput Appl Med Care 1991; 609-11.
- 38 Berman L, Miller RA. Problem area formation as an element of computer-aided diagnosis: a comparison of two strategies within Quick Medical Reference (QMR). Methods Inf Med 1991; 30 (02) 90-5.
- 39 Masarie Jr FE, Miller RA, Bouhaddou O, Giuse NB, Warner HR. An interlingua for electronic interchange of medical information: using frames to map between clinical vocabularies. Comp Biomed Res 1991; 24 (04) 379-400.
- 40 Miller RA, Jamnback L, Giuse NB, Masarie Jr FE. Extending the capabilities of diagnostic decision support programs through links to bibliographic searching: addition of “Canned MeSH Logic” to the Quick Medical Reference (QMR) program for use with Grateful Med. Proc Annu Symp Comput Appl Med Care 1991; 150-5.
- 41 Miller RA, Masarie FE. The Quick Medical Reference (QMR) Relationships Function: description and evaluation of a simple, efficient “multiple diagnoses” algorithm. Proc MEDINFO 92. Geneva, Switzerland:IMIA 1992; 512-8.
- 42 DeCillis A, Giuse DA, Thayer EH, Giuse NB, Miller RA. Using speech recognition in medical knowledge acquisition. Proc MEDINFO 92. Geneva, Switzerland:IMIA 1992; 1323-9.
- 43 Giuse NB, Giuse DA, Miller RA, Bankowitz RA, Janosky JE, Davidoff F. et al. Evaluating Consensus Among Physicians in Medical Knowledge Base Construction. Methods Inf Med 1993; 32: 137-45.
- 44 Giuse DA, Giuse NB, Miller RA. Consistency enforcement in medical knowledge base construction. Artif Intel Med 1993; 05: 245-52.
- 45 Giuse NB, Giuse DA, Bankowitz RA, Miller RA. Comparing contents of a knowledge base to traditional information sources. Proc Annu Symp Comput Appl Med Care 1993; 626-30.
- 46 Giuse DA, Giuse NB, Miller RA. Knowledge base editing with QMR-KAT. Proc Annu Symp Comput Appl Med Care 1993; 935.
- 47 Giuse DA, Giuse NB, Miller RA. Evaluation of Long-Term Maintenance of a Large Medical Knowledge Base. JAm Med InformAssoc 1995; 02: 297-306.
- 48 Aliferis CF, Cooper GF, Miller RA, Buchanan BG, Bankowitz RA, Giuse NB. A temporal analysis of QMR. J Am Med Inform Assoc 1996; 03: 79-91.
- 49 Rassinoux A-M, Miller RA, Baud RH, Scherrer J-R. Modeling principles for QMR medical find- ings. Proc Annu Symp Comput Appl Med Care 1996; 264-8.
- 50 Miller RA. Evaluating evaluations of medical di- agnostic systems. J Am Med Inform Assoc 1996; Nov-Dec; 03: 429-31.
- 51 Miller RA. A heuristic approach to the multiple diagnoses problem. In: Keravnou E, Garbay C, Baud R, Wyatt J, editors. Artificial Intelligence in Medicine, Proceedings of AIME 97. Lecture Notes in Artif icial Intelligence Series, #1211. Springer:Berlin 1997; 187-98.
- 52 Rassinoux A-M, Miller RA, Baud RH, Scherrer J-R. Compositional and enumerative designs for medical language representation. Proc Annu Symp Comput Appl Med Care 1997; 620-4.
- 53 Rassinoux A-M, Miller RA, Baud RH, Scherrer J-R. Modeling concepts in medicine for medical language understanding. Methods Inf Med 1998; Nov; 37 (4-5): 361-72.
- 54 Shwe MA, Middleton B, Heckerman DE, Henrion M, Horvitz EJ, Lehmann HP. et al. Probabilistic diagnosis using a reformulation of the INTERNIST1/QMR knowledge base. I. The probabilistic model and inference algorithms. Methods Inf Med 1991; Oct; 30 (04) 241-55.
- 55 Middleton B, Shwe MA, Heckerman DE, Henrion M, Horvitz EJ, Lehmann HP. et al. Probabilistic diagnosis using a reformulation of the INTERNIST1/QMR knowledge base. II. Evaluation of diagnostic performance. Methods Inf Med 1991; Oct; 30 (04) 256-67.
- 56 Shwe M, Cooper G. An empirical analysis of likelihood-weighting simulation on a large, multiply connected medical belief network. Comput Biomed Res 1991; Oct; 24 (05) 453-75.
- 57 Shiffman S, Lane CD, Johnson KB, Fagan LM. The integration of a continuous-speech-recognition system with the QMR diagnostic program. Proc Annu Symp Comput Appl Med Care 1992; 767-71.
- 58 Berner ES, Webster GD, Shugerman AA, Jackson JR, Algina J, Baker AL. et al. Performance of Four Computer-Based Diagnostic Systems. N Engl J Med 1994; Jun 23; 330 (25) 1792-6.
- 59 van Ginneken AM, Liem EB, Moorman PW. Integrating QMR with a computer-based patient record. ProcAnnu Symp Comput Appl Med Care 1993; 98-102.
- 60 Gozum ME. Emulating cognitive diagnostic skills without clinical experience: a report of medical students using Quick Medical Reference and Iliad in the diagnosis of difficult clinical cases. Proc Annu Symp Comput Appl Med Care 1994; 991.
- 61 Welford CR. A comprehensive computerized patient record with automated linkage to QMR. Proc Annu Symp Comput Appl Med Care 1994; 814-8.
- 62 Wolfram DA. An appraisal of INTERNIST-I. Artif Intell Med 1995; Apr; 07 (02) 93-116.
- 63 Berner ES, Jackson JR, Algina J. Relationships among performance scores of four diagnostic decision support systems. J Am Med Inform Assoc 1996; May-Jun; 03 (03) 208-15.
- 64 Arene I, Ahmed W, Fox M, Barr CE, Fisher K. Evaluation ofquickmedicalreference(QMR)asateaching tool. MD Comput 1998; Sep-Oct; 15 (05) 323-6.
- 65 Lemaire JB, Schaefer JP, Martin LA, Faris P, Ainslie MD, Hull RD. Effectiveness of the Quick Medical Reference as a diagnostic tool. CMAJ 1999; Sep 21; 161 (06) 725-8.
- 66 Berner ES, Maisiak RS, Cobbs CG, Taunton OD. Effects of a decision support system on physicians’ diagnostic performance. J Am Med Inform Assoc 1999; Sep; 06 (05) 420-7.
- 67 Berner ES, Maisiak RS. Influence of case and physician characteristics on perceptions of decision support systems. J Am Med Inform Assoc 1999; Sep-Oct; 06 (05) 428-34.
- 68 Friedman CP, Elstein AS, Wolf FM, Murphy GC, Franz TM, Heckerling PS. et al. Enhancement of clinicians’ diagnostic reasoning by computer-based consultation: a multisite study of 2 systems. JAMA 1999; Nov 17; 282 (19) 1851-6.
- 69 Schaffner KF. Medical informatics and the concept of disease. Theor Med Bioeth 2000; Jan; 21 (01) 85-101.
- 70 Shortliffe EH. Computer-based medical consultation: MYCIN. New York: Elsevier; 1976
- 71 Newell A, Simon HA. Human Problem Solving. Prentice Hall: Englewood Cliffs, NJ; 1972
- 72 Barnett GO. The application of computer-based medical record systems in ambulatory practice. N Engl J Med 1984; 310 (25) 1643-50.
- 73 Berner ES, Graber ML. editors. Diagnostic Error in Medicine. Adv Health Sci Educ Theory Pract. 2009. Sep; 14 Suppl 1 1-112 Epub 2009 Aug 12. ISSN 1382-4996 (Print) 1573-1677 (Online).
- 74 Newman-Toker DE, Pronovost PJ. Diagnostic Errors— The Next Frontier for Patient Safety. JAMA 2009; 301 (10) 1060-2.
- 75 Bernstein LM, Siegel ER, Goldstein CM. The hepatitis knowledge base. A prototype information transfer system. Ann Intern Med 1980; Jul; 93 (1 Pt 2): 169-81.
- 76 Clancey WJ, Leitsinger R. NEOMYCIN: reconfiguring a rule-based expert system for application to teaching. Proc 7th Internat Joint Conf Artific Intel. Vancouver, BC, Canada. San Francisco: Morgan Kaufmann Inc; 1981: 829-36.
- 77 Sackett DL, Rosenberg WM, Gray JA, Haynes RB, Richardson WS. Evidence based medicine: what it is and what it isn’t. BMJ 1996; Jan 13; 312 (7023): 71-2.
- 78 Friedman C. A “Fundamental Theorem” of Biomedical Informatics. J Am Med Inform Assoc 2009; 16: 169-70.
- 79 Stead WW, Haynes RB, Fuller S, Friedman CP, Travis LE, Beck JR. et al. Designing medical informatics research and library—resource projects to increase what is learned. JAm Med InformAssoc 1994; 01 (01) 28-33.
Correspondence to:
Randolph A. Miller, MD
Donald A.B. and Mary M. Lindberg University Professor
Department of Biomedical Informatics
Vanderbilt University Medical Center Room B003C Eskind Biomedical Library 2209 Garland Avenue
Nashville, TN 37232-8340
-
References
- 1 Collen MF. A History of Medical Informatics in the United States: 1950 to 1990. Bethesda, MD: Amer Med Informatics Assoc; 1995: 489 pages. ISBN 0-9647743-0-5..
- 2 Miller RA. Medical diagnostic decision support systems: past, present, and future. J Am Med Inform Assoc 1994; 01: 827.
- 3 Miller RA. Computer-assisted diagnostic decision support: history, challenges, and possible paths forward. Adv Health Sci Educ Theory Pract 2009; Sep; 14 Suppl (Suppl. 01) 89-106 Epub 2009 Aug 12. PMID: 19672686..
- 4 Pople HE, Myers JD, Miller RA. DIALOG:A model of diagnostic logic for internal medicine. In: Proc Fourth Internat Joint Conf Artif Intel. Cambridge, Massachusetts: MIT Artificial Intelligence Laboratory Publications. 1975: 848-55.
- 5 Miller RA, Schaffner KF. The logic of problemsolving in clinical diagnosis: a course for secondyear medical students. J Med Ed 1982; 57: 63-5.
- 6 Miller RA, Pople Jr HE, Myers JD. INTERNIST-1, An Experimental Computer-based Diagnostic Consultant for General Internal Medicine. N Engl J Med 1982; 307: 468-76.
- 7 Pople Jr HE. Heuristic methods for imposing structure on ill-structured problems: the structuring of medical diagnostics. In Szolovits P. (ed): Artificial Press; (AAAS Symposium Series, no. 51). 1982: 119-190.
- 8 Miller RA. Diagnostic and Prognostic Decision making Systems:A Survey of Recent Developments in the United States. In: Koehler CO, Tautu P, Wagner G. editors. Der Beitrag der Informationsver- arbeitung zum Fortschritt der Medizin. Medizinische Informatik und Statistic series, #50. Proceedings of the 28th Jahrestagung, Deutsche Gesellschaft fur Medizinische Dokumentation, Informatik und Statistik. Heidelberg, Germany: Springer Verlag; 1983
- 9 Miller RA. INTERNIST-1/CADUCEUS: Problems Facing Expert Consultant Programs. Methods Inf Med 1984; 23: 9-14.
- 10 Miller RA. A Computer-based Patient Case Simulator. Clin Res 1984; 32: 651A.
- 11 First MB, Soffer LJ, Miller RA. QUICK (QUick Index to Caduceus Knowledge): Using the INTERNIST-1/CADUCEUS Knowledge Base As An ElectronicTextbook of Medicine. Comp Biomed Res 1985; Apr; 18 (02) 137-65.
- 12 Miller RA, Schaffner KF, Meisel A. Ethical and Legal Issues Related to the Use of Computer Programs in Clinical Medicine. Ann Intern Med 1985; 102: 529-36.
- 13 Miller RA. INTERNIST-1, An Experimental Program for Consultation in General Internal Medicine: A Critical Review of its Approach to the Use of Laboratory Information for Diagnosis. In: Proc 32nd Meeting Japan Soc Clin Path. Matsumoto, Japan; September, 1985
- 14 Masarie Jr FE, Miller RA, Myers JD. INTERNIST-1 PROPERTIES:RepresentingCommonSenseandGood MedicalPracticeinaComputerizedMedicalKnowledge Base. Comp Biomed Res 1985; 18: 458-79.
- 15 Miller RA, Masarie Jr FE, Myers JD. “Quick Medical Reference” for diagnostic assistance. MD Computing 1986; 03: 34-48.
- 16 Heckerman D, Miller RA. Towards a better understanding of the INTERNIST-1 knowledge base. In: Salamon R, Blum B, Jorgenson M. editors. Proc MEDINFO 86. Washington, D.C: 1986: 22-6.
- 17 Miller RA, McNeil MA, Challinor S, Masarie Jr FE, Myers JD. Status Report: The INTERNIST-1 / Quick Medical Reference Project. West J Med 1986; 145: 816-22.
- 18 Miller RA. Computer based Diagnostic Decision making. Medical Care 1987; 25 (12) S148-S152.
- 19 Bankowitz RA, Blumenfeld BH, Miller RA. User variability in Abstracting and entering printed case histories with Quick Medical Reference (QMR). Proc 11th Annu Symp Comput Appl Med Care. Washington, DC: IEEE Press; 1987: 68-73.
- 20 Parker RC, Miller RA. Using causal knowledge to create simulated patient cases: The CPCS project as an extension of INTERNIST 1. Proc 11th Annu Symp Comput Appl Med Care. Washington, DC: IEEE Press; 1987: 473-80.
- 21 Lincoln M, Turner C, Hesse B, Miller RA. A comparison of Clustered Knowledge Structures in Iliad and in Quick Medical Reference. Proc 12th Annu Symp Comput Appl Med Care. Washington, DC: IEEE Press; 1988: 131-5.
- 22 Giuse NB, Giuse DA, Miller RA. Computer assisted multi-center creation of medical knowledge Care. Washington, DC: IEEE Press; 1988: 583-90.
- 23 Giuse NB, Bankowitz RA, Giuse DA, Parker RC, Miller RA. Medical Knowledge Base Acquisition: The Role of the Expert Review Process in Disease Profile Construction. Proc 13th Annu Symp Comput Appl Med Care 1989; 105-9.
- 24 Wagner MM, Bankowitz RA, McNeil MA, Challinor SM, Janosky JE, Miller RA. The diagnostic importance of the history and physical examination as determined by the use of a medical decision support system. Proc 13th Annu Symp Comput Appl Med Care 1989; 139-44.
- 25 Bankowitz RA, McNeil MA, Challinor SM, Parker RC, Kapoor WN, Miller RA. A computerassisted medical diagnostic consultation service: implementation and prospective evaluation of a prototype. Ann Intern Med 1989; 110: 824-32.
- 26 Miller RA, Masarie Jr FE. Use of the Quick Medical Reference (QMR) program as a tool for medical education. Methods Inf Med 1989; 28: 340-5.
- 27 Parker RC, Miller RA. Creation of a knowledge base adequateforsimulatingpatientcases:addingdeepknowledge to the INTERNIST-1/QMR Knowledge Base. Methods Inf Med 1989; 28: 346-51.
- 28 Bankowitz RB, McNeil MA, Challinor SM, Miller RA. Effect of a computer-assisted general medicine diagnostic consultation service on house staffdiagnosticstrategy. Methods Inf Med 1989; 28: 352-6.
- 29 Giuse NB, Giuse DA, Miller RA. Medical knowledge base construction as a means of introducing students to medical informatics. Proc Internat Symp Med Informat Educ. IMIA:Victoria, BC May 1989; 228-32.
- 30 Miller RA, Masarie Jr FE. The demise of the “Greek Oracle” model for medical diagnostic systems. Methods Inf Med 1990; 29: 1-2.
- 31 Miller RA. Why the standard view is standard: people, not machines, understand patients’ problems. J Med Philos 1990; 15: 581-91.
- 32 Giuse DA, Giuse NB, Miller RA. Towards computer assisted maintenance of medical knowledge bases. Artif Intel Med 1990; 02: 21-33.
- 33 Mabry ME, Miller RA. Distinguishing drug toxicity syndromes from medical diseases: a QMR computer-based approach. Proc 14th Annu Symp Comput Appl Med Care. Washington, DC:IEEE Computer Society Press 1990; 65-71.
- 34 Miller RA, Giuse NB. The medicine in medical informatics: medical knowledge bases. Acad Med 1991; 66 (01) 15-7.
- 35 Giuse DA, Giuse NB, Bankowitz RA, Miller RA. Heuristic determination of quantitative data for knowledge acquisition in medicine. Comput Biomed Res 1991; 24 (03) 261-72.
- 36 Shiffman S, Wu AW, Poon AD, Lane CD, Middleton B, Miller RA. et al. Building as peechinter facetoamedical diagnostic system. IEEE Expert 1991; 06: 41-50.
- 37 Bankowitz RA, Miller JK, Janosky J. A prospective analysis of inter-rater agreement between a physician and a physician’s assistant in selecting QMR vocabulary terms. Proc Annu Symp Comput Appl Med Care 1991; 609-11.
- 38 Berman L, Miller RA. Problem area formation as an element of computer-aided diagnosis: a comparison of two strategies within Quick Medical Reference (QMR). Methods Inf Med 1991; 30 (02) 90-5.
- 39 Masarie Jr FE, Miller RA, Bouhaddou O, Giuse NB, Warner HR. An interlingua for electronic interchange of medical information: using frames to map between clinical vocabularies. Comp Biomed Res 1991; 24 (04) 379-400.
- 40 Miller RA, Jamnback L, Giuse NB, Masarie Jr FE. Extending the capabilities of diagnostic decision support programs through links to bibliographic searching: addition of “Canned MeSH Logic” to the Quick Medical Reference (QMR) program for use with Grateful Med. Proc Annu Symp Comput Appl Med Care 1991; 150-5.
- 41 Miller RA, Masarie FE. The Quick Medical Reference (QMR) Relationships Function: description and evaluation of a simple, efficient “multiple diagnoses” algorithm. Proc MEDINFO 92. Geneva, Switzerland:IMIA 1992; 512-8.
- 42 DeCillis A, Giuse DA, Thayer EH, Giuse NB, Miller RA. Using speech recognition in medical knowledge acquisition. Proc MEDINFO 92. Geneva, Switzerland:IMIA 1992; 1323-9.
- 43 Giuse NB, Giuse DA, Miller RA, Bankowitz RA, Janosky JE, Davidoff F. et al. Evaluating Consensus Among Physicians in Medical Knowledge Base Construction. Methods Inf Med 1993; 32: 137-45.
- 44 Giuse DA, Giuse NB, Miller RA. Consistency enforcement in medical knowledge base construction. Artif Intel Med 1993; 05: 245-52.
- 45 Giuse NB, Giuse DA, Bankowitz RA, Miller RA. Comparing contents of a knowledge base to traditional information sources. Proc Annu Symp Comput Appl Med Care 1993; 626-30.
- 46 Giuse DA, Giuse NB, Miller RA. Knowledge base editing with QMR-KAT. Proc Annu Symp Comput Appl Med Care 1993; 935.
- 47 Giuse DA, Giuse NB, Miller RA. Evaluation of Long-Term Maintenance of a Large Medical Knowledge Base. JAm Med InformAssoc 1995; 02: 297-306.
- 48 Aliferis CF, Cooper GF, Miller RA, Buchanan BG, Bankowitz RA, Giuse NB. A temporal analysis of QMR. J Am Med Inform Assoc 1996; 03: 79-91.
- 49 Rassinoux A-M, Miller RA, Baud RH, Scherrer J-R. Modeling principles for QMR medical find- ings. Proc Annu Symp Comput Appl Med Care 1996; 264-8.
- 50 Miller RA. Evaluating evaluations of medical di- agnostic systems. J Am Med Inform Assoc 1996; Nov-Dec; 03: 429-31.
- 51 Miller RA. A heuristic approach to the multiple diagnoses problem. In: Keravnou E, Garbay C, Baud R, Wyatt J, editors. Artificial Intelligence in Medicine, Proceedings of AIME 97. Lecture Notes in Artif icial Intelligence Series, #1211. Springer:Berlin 1997; 187-98.
- 52 Rassinoux A-M, Miller RA, Baud RH, Scherrer J-R. Compositional and enumerative designs for medical language representation. Proc Annu Symp Comput Appl Med Care 1997; 620-4.
- 53 Rassinoux A-M, Miller RA, Baud RH, Scherrer J-R. Modeling concepts in medicine for medical language understanding. Methods Inf Med 1998; Nov; 37 (4-5): 361-72.
- 54 Shwe MA, Middleton B, Heckerman DE, Henrion M, Horvitz EJ, Lehmann HP. et al. Probabilistic diagnosis using a reformulation of the INTERNIST1/QMR knowledge base. I. The probabilistic model and inference algorithms. Methods Inf Med 1991; Oct; 30 (04) 241-55.
- 55 Middleton B, Shwe MA, Heckerman DE, Henrion M, Horvitz EJ, Lehmann HP. et al. Probabilistic diagnosis using a reformulation of the INTERNIST1/QMR knowledge base. II. Evaluation of diagnostic performance. Methods Inf Med 1991; Oct; 30 (04) 256-67.
- 56 Shwe M, Cooper G. An empirical analysis of likelihood-weighting simulation on a large, multiply connected medical belief network. Comput Biomed Res 1991; Oct; 24 (05) 453-75.
- 57 Shiffman S, Lane CD, Johnson KB, Fagan LM. The integration of a continuous-speech-recognition system with the QMR diagnostic program. Proc Annu Symp Comput Appl Med Care 1992; 767-71.
- 58 Berner ES, Webster GD, Shugerman AA, Jackson JR, Algina J, Baker AL. et al. Performance of Four Computer-Based Diagnostic Systems. N Engl J Med 1994; Jun 23; 330 (25) 1792-6.
- 59 van Ginneken AM, Liem EB, Moorman PW. Integrating QMR with a computer-based patient record. ProcAnnu Symp Comput Appl Med Care 1993; 98-102.
- 60 Gozum ME. Emulating cognitive diagnostic skills without clinical experience: a report of medical students using Quick Medical Reference and Iliad in the diagnosis of difficult clinical cases. Proc Annu Symp Comput Appl Med Care 1994; 991.
- 61 Welford CR. A comprehensive computerized patient record with automated linkage to QMR. Proc Annu Symp Comput Appl Med Care 1994; 814-8.
- 62 Wolfram DA. An appraisal of INTERNIST-I. Artif Intell Med 1995; Apr; 07 (02) 93-116.
- 63 Berner ES, Jackson JR, Algina J. Relationships among performance scores of four diagnostic decision support systems. J Am Med Inform Assoc 1996; May-Jun; 03 (03) 208-15.
- 64 Arene I, Ahmed W, Fox M, Barr CE, Fisher K. Evaluation ofquickmedicalreference(QMR)asateaching tool. MD Comput 1998; Sep-Oct; 15 (05) 323-6.
- 65 Lemaire JB, Schaefer JP, Martin LA, Faris P, Ainslie MD, Hull RD. Effectiveness of the Quick Medical Reference as a diagnostic tool. CMAJ 1999; Sep 21; 161 (06) 725-8.
- 66 Berner ES, Maisiak RS, Cobbs CG, Taunton OD. Effects of a decision support system on physicians’ diagnostic performance. J Am Med Inform Assoc 1999; Sep; 06 (05) 420-7.
- 67 Berner ES, Maisiak RS. Influence of case and physician characteristics on perceptions of decision support systems. J Am Med Inform Assoc 1999; Sep-Oct; 06 (05) 428-34.
- 68 Friedman CP, Elstein AS, Wolf FM, Murphy GC, Franz TM, Heckerling PS. et al. Enhancement of clinicians’ diagnostic reasoning by computer-based consultation: a multisite study of 2 systems. JAMA 1999; Nov 17; 282 (19) 1851-6.
- 69 Schaffner KF. Medical informatics and the concept of disease. Theor Med Bioeth 2000; Jan; 21 (01) 85-101.
- 70 Shortliffe EH. Computer-based medical consultation: MYCIN. New York: Elsevier; 1976
- 71 Newell A, Simon HA. Human Problem Solving. Prentice Hall: Englewood Cliffs, NJ; 1972
- 72 Barnett GO. The application of computer-based medical record systems in ambulatory practice. N Engl J Med 1984; 310 (25) 1643-50.
- 73 Berner ES, Graber ML. editors. Diagnostic Error in Medicine. Adv Health Sci Educ Theory Pract. 2009. Sep; 14 Suppl 1 1-112 Epub 2009 Aug 12. ISSN 1382-4996 (Print) 1573-1677 (Online).
- 74 Newman-Toker DE, Pronovost PJ. Diagnostic Errors— The Next Frontier for Patient Safety. JAMA 2009; 301 (10) 1060-2.
- 75 Bernstein LM, Siegel ER, Goldstein CM. The hepatitis knowledge base. A prototype information transfer system. Ann Intern Med 1980; Jul; 93 (1 Pt 2): 169-81.
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