Knowledge-Based Systems in Medicine

  • Edward H. Shortliffe
Conference paper
Part of the Lecture Notes in Medical Informatics book series (LNMED, volume 45)


In early 1990, Miller and Maserie described their belief that early approaches to computer-based decision support in medicine had been flawed in their adoption of the “Greek oracle” model of consultation [1]—computer programs to which a physician would turn for advice, answering patient-related questions but otherwise deferring to the dialog style and recommendations of the machine. The authors correctly observed that this model, adopted by many knowledge-based systems during the first decade of medical artificial-intelligence (AI) research [2], failed to capitalize on the special observational skills of physicians and failed to allow the user adequately to control the interaction, selecting the ways in which the program’s knowledge could most effectively be brought to bear in the consideration of a particular case. Their redesign of Internist-1’s interactive model in the development of the QMR system reflected their belief that the “Greek oracle” model should be laid to rest and replaced by a much more interactive and user-controlled approach to decision support.


Medical Informatics Grass Root Activity Visionary Leader Medical Diagnostic System Assume Leadership Role 
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  1. [1]
    Miller, R.A. and Maserie, F.E. “The Demise of the ‘Greek Oracle’ Model for Medical Diagnostic Systems.” Meth. Info. Med. (1990) 29: 1–2.Google Scholar
  2. [2]
    Clancey, W.J. and Shortliffe, E.H. (eds). Readings in Medical Artificial Intelligence: The First Decade. Reading, MA: Addison-Wesley, 1984.Google Scholar
  3. [3]
    Feigenbaum, E.A., McCorduck, P., and Nii, H.R The Rise of the Expert Company: How Visionary Companies are Using Artificial Intelligence to Achieve Higher Productivity and Products. New York: Times Books, 1988.Google Scholar
  4. [4]
    Greenes, R.A. and Shortliffe, E.H. “Medical Informatics: An Emerging Academic Discipline and Institutional Priority.” JAMA (1990) 263: 1114–1120.CrossRefGoogle Scholar
  5. [5]
    Shortliffe, E.H., Perreault, L.E., Wiederhold, G., and Fagan, L.M. (eds). Chapter 1 in Medical Informatics: Computer Applications in Health Care. Reading, MA: Addison-Wesley, 1990.Google Scholar
  6. [6]
    Matheson, N.W. and Cooper, J.A.D. “Academic Information in the Academic Health Sciences Center: Roles for the Library in Information Management.” J. Med. Educ. (1982) 57: 1–93.Google Scholar
  7. [7]
    Institute of Medicine. Report of the Committee to Improve the Patient Record. Washington, D.C.: National Academy Press, 1991.Google Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 1991

Authors and Affiliations

  • Edward H. Shortliffe
    • 1
  1. 1.Section on Medical InformaticsStanford UniversityStanfordUSA

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