Автор |
Langlotz, Curtis, P. |
Автор |
Shortliffe, Edward, H. |
Автор |
Fagan, Lawrence, M. |
Дата выпуска |
1988 |
dc.description |
Decision analysis is an appealing methodology with which to provide decision support to the practicing physician. However, its use in the clinical setting is impeded because computer- based explanations of decision-theoretic advice are difficult to generate without resorting to mathematical arguments. Nevertheless, human decision analysts generate useful and in tuitive explanations based on decision trees. To facilitate the use of decision theory in a computer-based decision support system, the authors developed a computer program that uses symbolic reasoning techniques to generate nonquantitative explanations of the results of decision analyses. A combined approach has been implemented to explain the differences in expected utility among branches of a decision tree. First, the mathematical relationships inherent in the structure of the tree are used to find any asymmetries in tree structure or inequalities among analogous decision variables that are responsible for a difference in expected utility. Next, an explanation technique is selected and applied to the most significant variables, creating a symbolic expression that justifies the decision. Finally, the symbolic expression is converted to English-language text, thereby generating an explanation that justifies the desirability of the choice with the greater expected utility. The explanation does not refer to mathematical formulas, nor does it include probability or utility values. The results suggest that explanations produced by a combination of decision analysis and symbolic processing techniques may be more persuasive and acceptable to clinicians than those produced by either technique alone. Key words: automated explanation; artificial intelligence; decision theory; decision support systems; medical informatics; stochastic simulation. (Med Decis Making 8:290-303, 1988) |
Издатель |
Sage Publications |
Название |
A Methodology for Generating Computer-based Explanations of Decision-theoretic Advice |
Тип |
Journal Article |
DOI |
10.1177/0272989X8800800410 |
Print ISSN |
0272-989X |
Журнал |
Medical Decision Making |
Том |
8 |
Первая страница |
290 |
Последняя страница |
303 |
Выпуск |
4 |
Библиографическая ссылка |
Beck JR, Letarte AL: Clinical decision analysis using Decision Maker. In: Ackerman MJ (ed): Proceedings of the Ninth Symposium on Computer Applications in Medical Care. Institute of Electrical and Electronic Engineers, 1985, pp 198-201 |
Библиографическая ссылка |
Beck JR: A convenient approximation of life expectancy (the "DEALE"). Am J Med73:889-897, 1982 |
Библиографическая ссылка |
Ben-Bassat M. , Carlson VK, Puri VK, et al: Pattern-based interactive diagnosis of multiple disorders: the MEDAS system. IEEE Trans Pattern Analysis Machine Intell 2:148-160, 1980 |
Библиографическая ссылка |
Buchanan BG, Shortliffe EH (eds): Rule-Based Expert Systems: The MYCIN Experiments of the Stanford Heuristic Programming Project. Reading, MA, Addison-Wesley, 1984 |
Библиографическая ссылка |
Burton RR, Brown JS: An investigation of computer coaching for informal learning activities . Int J Man-Machine Studies 11:5-24, 1979 |
Библиографическая ссылка |
Clancey WJ: Tutoring rules for guiding a case method dialogue. Int J Man-Machine Studies11:25-49, 1979 |
Библиографическая ссылка |
Clancey WJ: The epistemology of a rule-based expert system— a framework for explanation . Artif Intell 20:215-251, 1983 |
Библиографическая ссылка |
Clancey WJ, Shortliffe EH (eds): Readings in Medical Artificial Intelligence: The First Decade. Reading, MA, Addison Wesley, 1984 |
Библиографическая ссылка |
Cohen PR: Heuristic Reasoning About Uncertainty : An Artificial Intelligence Approach . Boston, Pitman, Research Notes in Artificial Intelligence, vol 2, 1985 |
Библиографическая ссылка |
Cooper GF: NESTOR: A Computer-based Medical Diagnostic Aid That Integrates Causal and Probabilistic Knowledge. PhD dissertation, Computer Science Department, Stanford University, November 1984. Rep. No. STAN-CS-84-48 [also numbered HPP-84-48] |
Библиографическая ссылка |
Cooper GF: A diagnostic method that uses causal knowledge and linear programming in the application of Bayes' formula. Comput Meth Progr Biomed22:223-237, 1986 |
Библиографическая ссылка |
Critchfield GC, Willard KE, Connelly DP: Probabilistic sensitivity analysis methods for general decision models. Comput Biomed Res19:254-265, 1986 |
Библиографическая ссылка |
Davis R., Buchanan B., Shortliffe E.: Production rules as a representation for a knowledge-based consultation program . Artif Intell 8:15-45, 1977 |
Библиографическая ссылка |
Doubilet P. , Begg CB, Weinstein MC, et al: Probabilistic sensitivity analysis using Monte Carlo simulation . Med Decis Making 5:157-177, 1985 |
Библиографическая ссылка |
Duda R., Hart P., Nilsson N.: Subjective Bayesian methods for rule-based inference systems. In: Proceedings 1976 National Computer Conference, Vol. 45, AFIPS, 1976 , pp 1075-1082 |
Библиографическая ссылка |
Good IJ: Weight of evidence, corroboration, explanatory power, information and the utility of experiments. JR Statist Soc B 22:319-331, 1960 |
Библиографическая ссылка |
Gorry GA, Kassirer JP, Essig A., et al: Decision analysis as the basis for computer-aided management of acute renal failure. Am J Med55:473-484, 1973 |
Библиографическая ссылка |
Heckerman DE : Probabilistic interpretations for MYCIN's certainty factors. In: Uncertainty in Artificial Intelligence . New York, North Holland, 1986, pp 167-196 |
Библиографическая ссылка |
Holtzman S. : Intelligent Decision Systems. PhD dissertation, Department of Engineering-Economic Systems, Stanford University, March 1985. Available from Strategic Decisions Group, Menlo Park, CA |
Библиографическая ссылка |
Kassirer JP , Pauker SG: The toss-up. N Engl J Med 305:1467-1469, 1981 |
Библиографическая ссылка |
Keeney RL: Value-driven expert systems. In: Keeney RL , Mohring RH, Otway H, et al (eds): Proceedings of the Conference on Multiattribute Decision Making via O.R.-based Expert Systems. Universitat Passau, April1986, pp 141-162 |
Библиографическая ссылка |
Kong A., Barnett GO, Mosteller F., et al: How medical professionals evaluate expressions of probability . N Engl J Med 315:740-744, 1986 |
Библиографическая ссылка |
Kosy DW, Wise BP: Self-explanatory financial planning models. In: Proceedings of the Fourth National Conference on Artificial Intelligence, AAAI-84, Austin, TX, 1984, pp 176-181 |
Библиографическая ссылка |
Kuipers BJ: Qualitative simulation. Artif Intell29:289-338, 1986 |
Библиографическая ссылка |
Langlotz CP , Shortliffe EH, Fagan LM: Using decision theory to justify heuristics . In: Proceedings of the Sixth National Conference on Artificial Intelligence, AAAI-86 , Philadelphia, 1986, pp 215-219 |
Библиографическая ссылка |
Langlotz CP , Fagan LM, Tu SW, et al: A therapy planning architecture that combines decision theory and artificial intelligence techniques , Comput Biomed Res 20:279-303, 1987 |
Библиографическая ссылка |
Lau J., Kassirer JP, Pauker SG: DECISION MAKER 3.0: improved decision analysis by personal computer . Med Decis Making 3:39-44, 1983 |
Библиографическая ссылка |
Mann WC, Bates N., Grosz B., et al: Text generation. Am J Computat Linguistics8:62-69, 1982 |
Библиографическая ссылка |
Miller PL: ATTENDING: critiquing a physician's management plan. IEEE Trans Pattern Analysis Machine Intell5:449-461, 1983 |
Библиографическая ссылка |
Miller PL: Expert Critiquing Systems: Practice-Based Medical Consultation by Computer . New York, Springer-Verlag , Computers and Medicine Series, 1986 |
Библиографическая ссылка |
Minsky M.: A framework for representing knowledge. In: The Psychology of Computer Vision . New York, McGraw-Hill, 1975, pp 211-277 |
Библиографическая ссылка |
Pepper S., Prytulak LS: Sometimes frequently means seldom: context effects in the interpretation of quantitative expressions. J Personality8:95-101, 1974 |
Библиографическая ссылка |
Pliskin JS, Shepard DS, Weinstein MC: Utility functions for life years and health status. Operations Res28:206-224, 1980 |
Библиографическая ссылка |
Politser PE : Explanations of statistical concepts: can they penetrate the haze of Bayes? Meth Informat Med 23:99-108, 1984 |
Библиографическая ссылка |
Reggia JA, Tuhrim S (eds): Computer-Assisted Medical Decision Making . New York, Springer-Verlag, 1985 |
Библиографическая ссылка |
Rennels GD: A Computational Model of Reasoning from the Clinical Literature. PhD dissertation, Program in Medical Information Science, Stanford University, June 1986 |
Библиографическая ссылка |
Rennels GD, Shortliffe EH, Miller PL: Choice and explanation in medical management: a multiattribute model of artificial intelligence approaches. Med Decis Making7:22-31, 1987 |
Библиографическая ссылка |
Scott AC, Clancey WJ, Davis R., et al: Explanation capabilities of production-based consultation systems . Am J Computat Linguistics (microfiche 62), 1977 [reprinted as chapter 10 in Buchanan and Shortliffe4] |
Библиографическая ссылка |
Shortliffe EH, Buchanan BG: A model of inexact reasoning in medicine . Math Biosci 23:351-379, 1975 |
Библиографическая ссылка |
Shortliffe EH: Computer-Based Medical Consultations: MYCIN. New York, Elsevier-North Holland , 1976 |
Библиографическая ссылка |
Shortliffe EH: The computer and medical decision making: good advice is not enough. IEEE Engineering in Medicine and Biology Magazine1:16-18, 1982 [adapted as chapter 32 in Buchanan and Shortliffe4] |
Библиографическая ссылка |
Slagle JR, Hamburger H.: An expert system for a resource allocation problem. Commun Assoc Comput Machinery28 :994-1004, 1985 |
Библиографическая ссылка |
Spiegelhalter DJ, Knill-Jones RP: Statistical and knowledge-based approaches to clinical decision-support systems, with an application in gastroenterology . JR Statist Soc A 147:35-77, 1984 |
Библиографическая ссылка |
Sullivan M. , Cohen PR: An endorsement-based plan recognition systems . In: Proceedings of the Ninth International Joint Conference on Artificial Intelligence, IJCAI-85, Los Angeles , August 1985, pp 475-479 |
Библиографическая ссылка |
Teach RL, Shortliffe EH: An analysis of physician attitudes regarding computer-based clinical consultation systems. Comput Biomed Res14:542-558, 1981 |
Библиографическая ссылка |
Wallis JW, Shortliffe EH: Explanatory power for medical expert systems: studies in the representation of causal relationships for clinical consultations. Meth Informat Med21:127-136, 1982 |
Библиографическая ссылка |
Weiner J.: BLAH, a system which explains its reasoning. Artif Intell15:19-48, 1980 |
Библиографическая ссылка |
Weinstein MC , Fineberg HV: Clinical Decision Analysis, Philadelphia, W.B. Saunders, 1980 |
Библиографическая ссылка |
Wellman M.: Probabilistic semantics for qualitative influences. In: Proceedings of the Sixth National Conference on Artificial Intelligence, AAAI-87 , Seattle, July 1987, pp 660-664 |