Skip to main content

Medical Expert Systems – A Study of Trust and Acceptance by Healthcare Stakeholders

  • Conference paper
  • First Online:

Part of the book series: Advances in Intelligent Systems and Computing ((AISC,volume 840))

Abstract

The increasing prevalence of complex technology in the form of medical expert systems in the healthcare sector is presenting challenging opportunities to clinicians in their quest to improve patients’ health outcomes. Medical expert systems have brought measurable improvements to the healthcare outcomes for some patients. This paper highlights the importance of trust and acceptance in the healthcare industry amongst receivers of the care as well as other stakeholders and between large healthcare organizations. Studies show that current conceptual trust models, which are being used to measure the degree of trust relationships in different healthcare settings, cannot be easily evaluated because of the resistance of organizational and social changes which are to be implemented. Research findings also suggest that the use of medical expert systems do not automatically guarantee improved patient healthcare outcomes. Furthermore, during the building of predictive and diagnostic expert medical systems, studies recommend the use of algorithms which can deal with noisy and imprecise data which is typical in healthcare data. Such algorithms include fuzzy rule based systems.

This is a preview of subscription content, log in via an institution.

Buying options

Chapter
USD   29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD   129.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD   169.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Learn about institutional subscriptions

References

  1. Alaszewski, A.: Risk, trust and health. Health Risk Soc. 5(3), 235–239 (2003). https://doi.org/10.1080/13698570310001606941

    Article  Google Scholar 

  2. Jones, J., Barry, M.M.: Developing a scale to measure trust in health promotion partnerships. Health Promot. Int. 26(4), 484–491 (2011)

    Article  Google Scholar 

  3. Ward, P.R., et al.: A qualitative study of patient (dis)trust in public and private hospitals: the importance of choice and pragmatic acceptance for trust considerations in South Australia. BMC Health Serv. Res. 15(1), 297 (2015). https://doi.org/10.1186/s12913-015-0967-0

    Article  Google Scholar 

  4. Turban, E., Aronson, J.E.: Decision Support Systems and Intelligent Systems. Prentice Hall, Upper Saddle River (2001)

    Google Scholar 

  5. Musen, M.A., Shahar, Y., Shortliffe, E.H.: Clinical decision-support systems. In: Biomedical Informatics Computer Applications in Health Care and Biomedicine, 3rd edn., pp. 698–736. Springer, USA (2006)

    Google Scholar 

  6. Musen, M.A., Middleton, B., Greenes, R.A.: Clinical decision-support systems. In: Shortliffe, E.H., Cimino, J.J. (eds.) Biomedical Informatics: Computer Applications in Health Care and Biomedicine, pp. 643–674. Springer, London (2014)

    Google Scholar 

  7. Alder, H., et al.: Computer-based diagnostic expert systems in rheumatology: where do we stand in 2014? Int. J. Rheumatol. (2014)

    Google Scholar 

  8. Walton, R.: An evaluation of CAPSULE, a computer system giving advice to general practitioners about prescribing drugs. J. Innov. Health Inform. [S.l.], 2–7 (1996). ISSN 2058-4563

    Google Scholar 

  9. Darlington, K.W.: Designing for explanation in health care applications of expert systems. SAGE Open 1(1) (2011). 2158244011408618

    Google Scholar 

  10. Metaxiotis, K., Psarras, J.: Expert systems in business: applications and future directions for the operations researcher. Ind. Manag. Data Syst. 103(5), 361–368 (2003). https://doi.org/10.1108/02635570310477

    Article  Google Scholar 

  11. Grol, R., Grimshaw, J.: From best evidence to best practice: effective implementation of change in patients’ care. Lancet 362(9391), 1225–1230 (2003)

    Article  Google Scholar 

  12. Ax, G., et al.: Effects of computerized clinical decision support systems on practitioner performance and patient outcomes: a systematic review. JAMA 293(10), 1223–1238 (2005)

    Article  Google Scholar 

  13. Castaneda, C., et al.: Clinical decision support systems for improving diagnostic accuracy and achieving precision medicine. J. Clin. Bioinform. 5(1), 4 (2015)

    Article  Google Scholar 

  14. Madkour, M.A., Roushdy, M.: Methodology for medical diagnosis based on fuzzy logic. In: Proceedings of Fifth International Conference on Soft Computing, vol. 2, pp. 1–14 (2016)

    Google Scholar 

  15. Stone, D.J., Csete, M.: Actuating critical care therapeutics. J. Crit. Care 35, 90–95 (2016)

    Article  Google Scholar 

  16. https://www.snomed.org/

  17. Benson, T.: SNOMED CT. In: Benson, T. (ed.) Principles of Health Interoperability HL7 and SNOMED, pp. 189–215 (2010). https://doi.org/10.1007/978-1-84882-803-2

  18. Appleby, J., Harrison, A., Devlin, N.: What Is the Real Cost of More Patient Choice?. King’s Fund, London (2003)

    Google Scholar 

  19. Leroy, G., Chen, H.: Introduction to the special issue on decision support in medicine. Decis. Support Syst. 43(4), 1203–1206 (2007)

    Article  Google Scholar 

  20. Arnold, V., Clark, N., Collier, P.A., Leech, S.A., Sutton, S.G.: The differential use and effect of knowledge-based system explanations in novice and expert judgement decisions. MIS Q. 30(1), 79–97 (2006)

    Article  Google Scholar 

  21. Berger, J.: Writing is an offshoot of something deeper (2014). https://www.theguardian.com/books/2014/dec/12/john-berger-writing-is-an-off-shoot-of-something-deeper

  22. Mayer, R.C., Davis, J.H., Schoorman, F.D.: An integrative model of organizational trust. Acad. Manag. Rev. 20, 709–734 (1995). Mayer, R.C., Gavin, M.B.: Trust (2005)

    Article  Google Scholar 

  23. Lewicki, R.J., Bunker, B.B.: Developing and maintaining trust in work relationships. Trust Organ. Front. Theory Res. 114–139 (1996)

    Google Scholar 

  24. Hall, G., Longman, J.: The Postgraduate Companion. Sage Publications, London (2008). Chapters 4–7 Eds

    Google Scholar 

  25. Mechanic, D., Meyer, S.: Concepts of trust among patients with serious illness. Soc. Sci. Med. 51(5), 657–668 (2000)

    Article  Google Scholar 

  26. Calnan, M., Rowe, R.: Researching trust relations in health care: conceptual and methodological challenges – an introduction. J. Health Organ. Manag. 20(5), 349–358 (2006)

    Article  Google Scholar 

  27. Tarrant, C., Stokes, T., Baker, R.: Factors associated with patients’ trust in their general practitioner: a cross-sectional survey. Br. J. Gen. Pract. 53(495), 798–800 (2003)

    Google Scholar 

  28. Mainous III, A.G., Baker, R., Love, M.M., Pereira Gray, D., Gill, J.M.: Continuity of care and trust in one’s physician: evidence from primary care in the United States and the United Kingdom. Fam. Med. 33, 22–27 (2001)

    Google Scholar 

  29. Calnan, M.W., Sanford, E.: Public trust in health care: the system or the doctor? BMJ Qual. Safety 13(2), 92–97 (2004). http://qualitysafety.bmj.com/content/13/2/92

    Article  Google Scholar 

  30. Harrison, S., Smith, C.: Neo-bureaucracy and public management: the case of medicine in the national health service. Competition Change 7(4), 243–254 (2003). https://doi.org/10.1080/1024529042000197077

    Article  Google Scholar 

  31. Khajouei, R., Jaspers, M.W.M.: The impact of CPOE medication systems’ design aspects on usability, workflow and medication orders a systematic review. Methods Inf. Med. 49(1), 3–19 (2010)

    Google Scholar 

  32. Larson, H.J., et al.: Addressing the vaccine confidence gap. Lancet 378(9790), 526–535 (2011). http://www.sciencedirect.com/science/article/pii/S0140673611606788

    Article  Google Scholar 

  33. Systems, B.I.: A fuzzy expert system for response determining diagnosis and management movement impairments syndrome Fatemeh Mohammadi Amiri. Ameneh Khadivar Alireza Dolatkhah 24(1), 31–50 (2017)

    Google Scholar 

  34. Lepage, E., et al.: ILIAD: an expert system for diagnostic assistance and teaching: implementation in France. In: Adlassnig, K.-P., et al. (eds.) Medical Informatics Europe 1991, pp. 629–633. Springer, Heidelberg (1991)

    Google Scholar 

  35. Mackin, N., Stephens, C.D.: Development and testing of a fuzzy expert system - an example in orthodontics. In: Proceedings of Fuzzy Logic: Applications and Future Directions, pp. 61–71. Unicom Seminars Ltd, Uxbridge, Middlesex (1997)

    Google Scholar 

  36. Nohria, R.: Medical expert system-A comprehensive review. Int. J. Comput. Appl. 130(7), 975–8887 (2015)

    Google Scholar 

  37. Hunt, D.L., et al.: Effects of computer-based clinical decision support systems on physician performance and patient outcomes - a systematic review. JAMA J. Am. Med. Assoc. 280(15), 1339 (1998)

    Article  Google Scholar 

  38. Edwards, G., Compton, P., Malor, R., Srinivasan, A., Lazarus, L.: PEIRS: a pathologist maintained expert system for the interpretation of chemical pathology reports. Pathology 25, 27–34 (1993)

    Article  Google Scholar 

  39. http://www.aesgrp.com/medical/medical-products/pathosys

  40. Safran, D.G., et al.: Linking primary care performance to outcomes of care. J. Family Pract. 47, 213–220 (1998)

    Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding authors

Correspondence to Ioannis Vourgidis , Paul Wilson or Jenny Carter .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2019 Springer Nature Switzerland AG

About this paper

Check for updates. Verify currency and authenticity via CrossMark

Cite this paper

Vourgidis, I., Mafuma, S.J., Wilson, P., Carter, J., Cosma, G. (2019). Medical Expert Systems – A Study of Trust and Acceptance by Healthcare Stakeholders. In: Lotfi, A., Bouchachia, H., Gegov, A., Langensiepen, C., McGinnity, M. (eds) Advances in Computational Intelligence Systems. UKCI 2018. Advances in Intelligent Systems and Computing, vol 840. Springer, Cham. https://doi.org/10.1007/978-3-319-97982-3_9

Download citation

Publish with us

Policies and ethics