INTERNIST-I, An Experimental Computer-Based Diagnostic Consultant for General Internal Medicine
INTERNIST-I is an experimental computer program capable of making multiple and complex diagnoses in internal medicine. It differs from most other programs for computer-assisted diagnosis in the generality of its approach and the size and diversity of its knowledge base. To document the strengths and weaknesses of the program we performed a systematic evaluation of the capabilities of INTERNIST-I. Its performance on a series of 19 clinicopathological exercises (Case Records of the Massachusetts General Hospital) published in the Journal appeared qualitatively similar to that of the hospital clinicians but inferior to that of the case discussants. The evaluation demonstrated that the present form of the program is not sufficiently reliable for clinical applications. Specific deficiencies that must be overcome include the program’s inability to reason anatomically or temporally, its inability to construct differential diagnoses spanning multiple problem areas, its occasional attribution of findings to improper causes, and its inability to explain its “thinking.” (N Engl J Med. 1982; 307:468–76.
KeywordsHepatic Encephalopathy Primary Biliary Cirrhosis General Internal Medicine Problem Area Ascitic Fluid
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- Pople HE, Myers JD, Miller RA. DIALOG: a model of diagnostic logic for internal medicine. In: Proceedings of the Fourth International Joint Conference on Artificial Intelligence. Cambridge, Mass.: MIT Artificial Intelligence Laboratory Publications, 1975:848–55.Google Scholar
- Myers JD, Pople HE, Miller RA. INTERNIST: can artificial intelligence help? In: Connelly, Benson, Burke, Fenderson, eds. Clinical decisions and laboratory use. Minneapolis: University of Minnesota Press, 1982:251–69.Google Scholar
- Pople HE. Heuristic methods for imposing structure on ill-structured problems: the structuring of medical diagnostics. In: Szolovits P, ed. Artificial intelligence in medicine, AAAS Symposium Series, Boulder, Colo.: West- view Press, 1982:119–85.Google Scholar
- Winston PH. Artificial intelligence. Reading, Mass.: Addison-Wesley, 1977.Google Scholar
- Nilsson NJ. Principles of artificial intelligence. Palo Alto: Tioga Publishing Co., 1980.Google Scholar
- Case Records of the Massachusetts General Hospital (Case 30-1969).N Engl J Med. 1969; 281:206–13.Google Scholar