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Abstract:Little significance is attached by medical informatics workers to the many practical issues which affect the development of clinical decision-support systems. We examine the current state of research in clinical decision-support, the characteristics and motivations of developers, and the perceptions of intended end-users. Factors which adversely affect the success of systems are highlighted and pointers to good practice discussed. We then propose a coherent approach to system development, consisting of requirements analysis, software design, implementation, testing, evaluation and maintenance.

This paper represents a personal perspective on the last 13 years of research in medical artificial intelligence and expert systems, and describes the progress of the discipline from its inception to its current status. The challenges faced by researchers are examined, and it is argued that (despite the claims) theoretical and technical limitations are not the major barriers to the successful implementation of medical artificial intelligence and expert systems, but rather more complex professional and organizational issues are at stake.

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