ARTIFICIAL INTELLIGENCE IN MEDICINE

Introduction to AI and Medicine Artificial Intelligence (AI) is a field that enables the computers to imitate human intelligence and to make computers more useful. AI stud ies are used to recognize the keys which make intelligence possible (Winston, P.W., 1977). Artificial Intelligence in medicine (AIM) is AI that specialized to medical applications. Medicine differs from others domains because of the objects are the patients. The patients are unique and very complex with high biological variance. History of AIM AI in medicine starts by transferring the administrative and financial record keeping system to computer systems (Szolovits, P., 1982). Later the usage expanded to storing and maintaining the patient medical records. The laboratory equipment also computerized and the data records kept for the practitioners reference. Data from clinical experiments also recorded and stored at this stage. Recently, the records that are accumulated and stored in the database are analyzed and used a s resource to build a trend and give information about particular events. The data and information are organized to give a concrete knowledge that benefits the organizations. Areas in AI There are a number of areas in Artificial Intelligence that divide in two here. Conventional Area ? ? ? ? ? ? Expert System Natural Language Processing Robotic Computer Vision Speech and Voice Understanding Intelligent Computer-Aided instruction

New Area ? ? ? ? ? ? Artificial Neural Networks Fuzzy Logic Genetic Algorithm Data Mining Case Base Reasoning Intelligent Agent

There are a number of clinical tasks where AI can be applied (Coiera, E., 1997). Generating Alert and reminders The systems can monitor and alert of the changes in a patients condition. Diagnostic Assistance The systems can assist the inexperienced practitioners diagnosis. The systems are also helpful in diagnosing complex or rare cases. Critiquing and planning treatment These systems can plan and formulate a treatment based on patients specific condition. Agents for information retrieval The software agents used to retrieve information that is relevant to a particular situation or request. The agents will keep in mind the users preference and act accordingly. Image recognition and interpretation The medical images can now be interpreted from X-rays to complex images like CT and MRI scans.

AI in Medicine Systems Below listed are a few clinical systems that already in used . ? Acute Care Systems ? ACORN This system is a Hybrid rule-based & Bayesian system for advising on management of chest pain patients in the emergency room. The system is used by senior nurses to manage these patients. ? VIE-PNN Vie-Pnn is a parenteral nutrition composition expert system in Intensive Care Unit. The system plans adequate nutrition support to maintain the metabolic needs of sick newborn babies treated at ICU (Horn, W. 2001). ? NEOGANESH Neoganesh is a knowledge-based system for the management of mechanical ventilation in Intensive Care Units (ICUs). The system interprets clinical data in real-time and control the mechanical assistance provided to patients who suffers from a lung disease. It uses objectoriented and forward chaining production rules. The system improves the quality f the patients ventilation and prediction of weaning.

? Decision Support Systems ? ORTHOPLANNER A knowledge based system to provide dentists with orthodontic treatment plans for cases where fixed orthodontic appliances techniques must be employed. Orthoplanner is a window based system that uses rule based reading, forward and backward chaining and fuzzy logic based representations of the orthodontic knowledge (Mackin, N., 1992). ? MDDB Diagnosis of dysmorphic syndromes built using case-based reasoning in a medical domain. ? Jeremiah A rule based /fuzzy logic system to provide dentists with orthodontic treatment plans for cases suitable for treatment by general dental practitioners with knowledge of removable orthodontic techniques. Jeremiah assists practitioners to select cases with suitable treatment with removable orthodontic appliances and to identify those requiring more special treatments. ? Laboratory System ? Coulter(R) FACULTY(TM) Coulter FACULTY Knowledge-Based System Software functions as a consultant, assists workflow, and acts as an educational tool in laboratory hematology. Dosechecker The system is to assist the staff pharmacists at Barnes and Jewish Hospitals with monitoring drug dosing for patients, particularly in patients with renal impairment. In these patients the drug concentrations can build to toxic levels if not carefully balanced. Dosechecker uses a relational database containing patient demographic information and clinical data such as serum creatinine measurements and drug orders.

? Educational Systems ? Cancer, Me?? The Expert system is for automate delivery of personal advice on how to reduce risk of cancer. The systems consultation divided into four sections which are Smoking and Smoke Exposure, Diet, Sun Exposure and Health Practices. The user can choose in any order they like. Questions about lifestyle, medical and personal background and family health history are asked directly or inferenced to gather information.

? Quality Assurance and Administration ? ADE (Adverse Drug Event) Monitor ADE is to assist the staff pharmacists at Barnes and Jewish Hospitals with monitoring patient clinical data for potential adverse drug events (ADEs).

? Quality Assurance and Administration ? Colorado Medicaid utilization review system It is an expert system which performs quality review of drug prescribing for Medicaid patients. ? Medical Imaging ? Perfex Perfex is a rule-based expert system for automatic interpretation of Cardiac SPECT data. The overall goal of this system is to assist in the diagnosis of coronary artery disease. The knowledge-based system presents the resulting diagnostics recommendations in both visual and textual forms in an interactive framework and enhances the overall utility. ? Phoenix ? Radiology Consultant that selects the most appropriate radiology procedures. The system improves the process of selecting imaging procedures.

Technique Used ? Bayesian Network ? Rule Base- Back Chaining ? Rule Base-Forward Chaining ? Case Base ? Fuzzy Logic ? Neural Network ? Multibackpropagation ? Probabilistic ? Ignorant Belief Networks Conclusion Medicine is an area that where help is very much needed in decreasing the practitioners workloads. AI in medicine can support and assist practitioner in making prompt decisions and provide more time for the practitioners to focus in other important tasks.

Reference Horn, W., (2001). AI in Medicine on its way from knowledge-intensive to data- intensive systems. Coiera, E., (1997). Guide to Medical Informatics, the Internet and Telemedicine. Chapman and Hall Medical. Frenster, J.H., (1989). Expert Systems and Open Systems in Medical Artificial Intelligence. Proc Am Assoc Medical Systems and Informatics, Congress89, vol.7, pages 118-120, 1989. Szolovits, P. (1982). Artificial Intelligence and Medicine. Chapter 1 in Szolovits, P. (Ed) Artificial Intelligence in Medicine. Westview Press, Boulder, Colorado. Artificial Intelligence Systems in Routine Clinical Use http://www.coiera.com/ailist/list- main.html