Do no harm: the insider threat to patient data

Abstract:Expert systems in medicine are frequently restricted to assisting the physician to derive a patient-specific diagnosis and therapy proposal. In many cases, however, there is a clinical need to use these patient data for other purposes as well. The intention of this paper is to show how and to what extent patient data in expert systems can additionally be used to create clinical registries and for statistical data analysis. At first, the pitfalls of goal-oriented mechanisms for the multiple usability of data are shown by means of an example. Then a data acquisition and inference mechanism is proposed, which includes a procedure for controlling selection bias, the so-called knowledge-based attribute selection. The functional view and the architectural view of expert systems suitable for the multiple usability of patient data is outlined in general and then by means of an application example. Finally, the ideas presented are discussed and compared with related approaches.

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The Medical Record: Narration and Story as a Path Through Patient Data

Methods of Information in Medicine ◽

10.1055/s-0038-1634650 ◽

1996 ◽

Vol 35 (02) ◽

pp. 88-92 ◽

Cited By ~ 3

Author(s):

E.-H. W. Kluge

Keyword(s):

Expert Systems ◽

Conceptual Framework ◽

Medical Record ◽

Patient Data ◽

Analog Model ◽

Patient Profile

AbstractKay and Purves' proposed narratological model of the medical record is based on the familiar phenomenological insight that the perception of data is conditioned by the conceptual framework of the perceiver. Unfortunately, unless handled very carefully, this approach will make the significance of a medical record unique to the person who constructed it and impermeable to outside scrutiny. However, when integrated into the analog-model of the medical record, the narratological model can be accommodated as the clinician-relative construction of a patient profile within the data that make up the medical record. Some implications for the construction of expert systems and competence analysis are indicated.

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