Fred E. Masarie

Building a speech interface to a medical diagnostic system

A description is given of the design of an interface for QMR-DT, an evolving decision-theoretic version of Quick Medical Reference, which performs diagnostic reasoning about diseases in internal medicine. QMR-DT encompasses the part of QMRs functionality that provides differential diagnoses for a set of patient characteristics, but it uses a different algorithm to compute diagnoses. The work described includes two programs that integrate off-the-shelf speech technology with programs that manipulate medical terminology. The term identifier program uses an isolated-word, speaker-dependent speech product to provide an interface for entering medical findings into QMR-DT. Frame browser is an auxiliary program used by the developers of term identifier to examine frame structures. Frame browser was also used to experiment with a continuous-speech system.<<ETX>>

Evaluation Issues in the Development of Expert Systems in Medicine

Evaluation of medical decision support software (MDSS) -computer programs to assist health professionals with diagnostic and/or therapeutic decisions -has not kept pace with the development of such programs. This article describes the following formative evaluation issues that must be addressed by developers of MDSS to evaluate these programs properly: (1) How can systematic feedback be obtained about an evolving program? (2) How can enough data to evaluate the program be obtained? (3) How much instruction is necessary? (4) What are the most important aspects for users to evaluate? and (5) How can the appropriate use of a developing MDSS be assured? Data from an ongoing evaluation of an existing MDSS, Quick Medical Reference, are used to illustrate the issues and to suggest recommendations for addressing them.