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With an acceptance that AIM must adopt health care's problems as its own comes a redefinition of goals.
With an acceptance that AIM must adopt health care’s problems as its own comes a redefinition of goals.
At the same time that AIM is redefining its priorities, medicine itself is undergoing a quiet revolution known as “evidence-based medicine,” and this may well transform the nature of clinical practice.’ The mountain of research produced by medicine each week is now so great that the time lag between a treatment being proven effective and actually coming into routine . For example, the first trial to show that streptokinase was useful in treating myocardial infraction was published in 1959. Convincing evidence mounted in the early 197Os, and the first multitribal meta-analysis proving the drug’s value was published in the early 1980s. However, formal advice that streptokinase was useful in the routine treatment of myocardial infarction only appeared in the late 1980s. It should be enormously exciting to AIM researchers that medicine’s technical problems are ones that AI may be able to help solve.
Therefore, AIM’s skills in knowledge acquisition and representation are needed to help develop methods that allow doctors to compare newly published data with existing guidelines and to update the knowledge base as appropriate. Work has already been underway in these areas for some time, but much remains to be done.13-15Ultimately, what is required is a way for practicing clinicians to access such guidelines quickly, incorporate them into their clinical practices, and then submit their own experiences back to the knowledge base to help improve it.
This raises one final challenge whose impact has yet perhaps to be fully appreciated the rise of the Internet. The Internet is important for two reasons. First, it seems to be custom made to solve some of the inherent communications problems that are at the heart of creating a truly evidence based medical practice.
Its second lesson is perhaps subtler but may in the long run prove to be as important for AIM. Computer science, and AI in particular, is based on the power of formalizing knowledge representation and reasoning. Artificial intelligence in medicine is focused on developing ways of formalizing everything from diagnosis to the terminology medicine uses. Yet, the Internet’s growth has probably been possible only because it formalizes so little. When it comes to defining how one should publish on the Internet, less is definitely more.
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