Case-based medical informatics
Date
2004-11-08
Authors
Pantazi, Stefan V
Arocha, José F
Moehr, Jochen R
Journal Title
Journal ISSN
Volume Title
Publisher
BioMed Central
Abstract
Background: The "applied" nature distinguishes applied sciences from theoretical sciences. To emphasize
this distinction, we begin with a general, meta-level overview of the scientific endeavor. We introduce the
knowledge spectrum and four interconnected modalities of knowledge. In addition to the traditional
differentiation between implicit and explicit knowledge we outline the concepts of general and individual
knowledge. We connect general knowledge with the "frame problem," a fundamental issue of artificial
intelligence, and individual knowledge with another important paradigm of artificial intelligence, case-based
reasoning, a method of individual knowledge processing that aims at solving new problems based on the
solutions to similar past problems.
We outline the fundamental differences between Medical Informatics and theoretical sciences and propose
that Medical Informatics research should advance individual knowledge processing (case-based reasoning)
and that natural language processing research is an important step towards this goal that may have ethical
implications for patient-centered health medicine.
Discussion: We focus on fundamental aspects of decision-making, which connect human expertise with
individual knowledge processing. We continue with a knowledge spectrum perspective on biomedical
knowledge and conclude that case-based reasoning is the paradigm that can advance towards personalized
healthcare and that can enable the education of patients and providers.
We center the discussion on formal methods of knowledge representation around the frame problem.
We propose a context-dependent view on the notion of "meaning" and advocate the need for case-based
reasoning research and natural language processing. In the context of memory based knowledge
processing, pattern recognition, comparison and analogy-making, we conclude that while humans seem to
naturally support the case-based reasoning paradigm (memory of past experiences of problem-solving and
powerful case matching mechanisms), technical solutions are challenging.
Finally, we discuss the major challenges for a technical solution: case record comprehensiveness,
organization of information on similarity principles, development of pattern recognition and solving ethical
issues.
Summary: Medical Informatics is an applied science that should be committed to advancing patientcentered
medicine through individual knowledge processing. Case-based reasoning is the technical
solution that enables a continuous individual knowledge processing and could be applied providing that
challenges and ethical issues arising are addressed appropriately.
Description
BioMed Central
Keywords
Citation
Pantazi SV, Arocha JF, Moehr JR: Case-based medical informatics. BMC Med Inform Decis Mak 2004, 4:19