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Features of a Knowledge-Based CDSS

knowledge base,

. The knowledge base contains the rules and associations of compiled data which
most often take the form of IF-THEN rules. If this was a system for determining drug
interactions, then a rule might be that IF drug X is taken AND drug Y is taken THEN
alert user. Using another interface, an advanced user could edit the knowledge base
to keep it up to date with new drugs

The knowledge base is the heart of the system and contains the knowledge needed
for solving a specific problem. The knowledge may be in the form of facts, heuristics
(e.g. experiences, opinions, judgments, predictions, algorithms) and relationships
usually gleaned from the mind of experts through specific knowledge acquisition
methods (e.g. interview) in the relevant domain. Knowledge can be represented
using a variety of representation techniques (e.g. semantic nets, frames, predicate
logic) (Ignizio, 1991; Mital and Anand, 1994), but the most commonly used technique
is if-then rules, also known as production rules.

inference engine

The inference engine combines the rules from the knowledge base with the patients
data.

The inference engine is employed during a consultation session, examines the status
of the knowledge base, handles the content of the knowledge base and determines
the order in which inferences are made. It may use various inference methods. Many
inference engines have the capability for reasoning in the presence of uncertainty

mechanism to communicate/user interface

The communication mechanism will allow the system to show the results to the user
as well as have input into the system

The user interface part enables interaction of the system with the user. It mainly
includes screen displays, a consultation/advice dialogue and an explanation
component. In addition, expert systems provide interfaces for communication with
external programs including databases and spreadsheets.

Knowledge-Acquisition Interface

The knowledge-acquisition interface controls how the expert and knowledge engineer
interact with the program to incorporate knowledge into the knowledge base. It
includes features to assist experts in expressing their knowledge in a form suitable for
reasoning by the computer

This process of expressing knowledge in the knowledge base is called knowledge


acquisition. Knowledge acquisition turns out to be quite difficult in many cases--so
difficult that some authors refer to the knowledge acquisition bottleneck to indicate
that it is this aspect of expert system development which often requires the most time
and effort

Debugging faulty knowlege bases is facilitated by traces (lists of rules in the order
they were fired), probes (commands to find and edit specific rules, facts, and so on),
and bookkeeping functions and indexes (which keep track of various features of the

knowledge base such as variables and rules). Some rule-based expert system shells
for personal computers monitor data entry, checking the syntactic validity of rules.
Expert systems are typically validated by testing their preditions for several cases
against those of human experts. Case facilities--permitting a file of such cases to be
stored and automatically evaluated after the program is revised--can greatly speed
the vaidation process. Many features that are useful for the user interface, such as
on-screen help and explanations, are also of benefit to the developer of expert
systems and are also part of knowledge-acquisition interfaces

Features of a non-Knowledge-Based CDSS


Two types of non-knowledge-based systems are

artificial neural networks

genetic algorithms

Artificial neural networks use nodes and weighted connections between them to analyze the
patterns found in the patient data to derive the associations between the symptoms and a
diagnosis. This eliminates the need for writing rules and for expert input. However since the
system cannot explain the reason it uses the data the way it does, most clinicians dont use
them for reliability and accountability reasons.
Genetic Algorithms are based on simplified evolutionary processes using directed selection to
achieve optimal CDSS results. The selection algorithms evaluate components of random sets
of solutions to a problem. The solutions that come out on top are then recombined and
mutated and run through the process again. This happens over and over till the proper
solution is discovered. They are the same as neural networks in that they derive their
knowledge from patient data.

Non-knowledge-based networks often focus on a narrow list of symptoms like ones for a single
disease as opposed to the knowledge based approach which cover many different diseases to
diagnosis.

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The basic architecture of an expert system is the inference engine and the
knowledge base containing the domain knowledge usually stored in the form of
rules.' Another component, called the user interface, which provides a means of
communicating with an expert system is also part of the basic architecture.
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search for hybrid expert system architecture. Real time forward chaining
architecture and backward chaining architectures

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The rules are of the standard "if ... then ..." format. In an ideal version of the
system users would be able to express their rules in natural language:
The domain expert sets up a particular world by modelling the different types
of object, specifying attributes they should have and their default values, and
writing the main behavioural rules they follow. The domain expert may also
specify some lower-level domain-specific predicates and operators.

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When a rule engine is run under the forward-chaining method, it goes through three
main stages:
1. Match the rules with the facts by testing the conditional part of every rule with
all subsets of facts. As a rule can match with more than one set of facts, pairs
of rules and fact subsets are denoted instantiations. In Drools, they are referred
to as Activations. The set of instantiations is sometimes called the conflict set.
2. Select and order the instantiations or Activations for execution. In Drools, the
Activations selected are placed on an Agenda for execution.
3. Execute the rules in the order specified. Rule execution may trigger other
programs, or may also update the facts, requiring rules to be re-matched.

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