Choice and Explanation in Medical Management

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Abstract
This paper explores a model of choice and explanation in medical management and makes clear its advantages and limitations. The model is based on multiattribute decision making (MADM) and consists of four distinct strategies for choice and explanation, plus combinations of these four. Each strategy is a restricted form of the general MADM approach, and each makes restrictive assumptions about the nature of the domain. The advantage of tailoring a restricted form of a general technique to a particular domain is that such efforts may better capture the character of the domain and allow choice and explanation to be more naturally modelled. The uses of the strategies for both choice and explanation are illustrated with analyses of several existing medical management artificial intelligence (Al) systems, and also with examples from the management of primary breast cancer. Using the model it is possible to identify common underlying features of these Al systems, since each employs portions of this model in different ways. Thus the model enables better understanding and characterization of the seemingly ad hoc decision making of previous systems. Key words: artificial intelligence; expert systems; explanation; medical management. (Med Decis Making 7:22-31, 1987)

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