Medical Knowledge and Decision Making

Reference: Shortliffe, E. H. Medical Knowledge and Decision Making. September, 1988.

Abstract: A retrospective special issue of a journal provides a remarkable opportunity for taking a step back from one's day-to-day focus on specific research questions and, instead, to trace the trends which have defined a field's evolution. It is a tribute to this journal that many influential articles in the field of medical decision making have appeared in its pages. It made the editor's task difficult, however, in that we needed to select representative papers from over a 20-year period. Many other key papers, not included here, are also worth retrieving form the archives. There are two reasons for doing so. First, those who are new to the field may not be familiar with some wonderful early papers that continue to be thought provoking and influential. Second, this reviewer has found it fascinating to reread some of the earlier papers from the fresh perspective of the late 1980s. I am reminded of the observation that most ideas are not really new but simply reexpressed; one will find that many concepts that are currently in vogue were described, albeit using different terminology, in excellent articles that appeared two or more decades ago. In this brief overview of computer-assisted medical decision making, I will trace the field from a historical perspective. Essentially all the major themes in medical decision-making research are reflected in the articles included in these pages, and the bibliography at the end of this introduction will provide some additional key references. Of related interest are a pair of articles from the journal Medical Decision Making; they provide a citation analysis for the field in 1984 [2] and again in 1988 [24].

Notes: 14 pages.

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