The Use of Information in Clinical Problem-Solving
A Framework for Analysis
A systems-analysis framework for the organization of information in a biomedical communication network. Formal structures need to be developed to improve information handling in medicine. Tutorial constructs show relationships between present practice and medical information. Decisions under physician control are initial workup (history, examination, and lab reports), diagnosis, and therapy. Depending on the kind of information known, the physician may use supportive, patient-specific, or disease-specific therapy, or may adopt a multiple-problem policy. Each approach emphasizes a different aspect of clinical problem-solving. Further, any decision process will be subject to the factors of environment, time, uncertainty, goals, and constraints. The domination of each of these will vary the set of decisionmaking rules. Each set of variables has different dimensions. The observables may be considered as data per patient; the conceptual state variables, data per problem; the decision variable, time per problem; and control variables, data per time problem.