Causal reasoning in medicine: Analysis of a protocol

The ability to identify and represent the knowledge that a human expert has about a particular domain is a key method in the creation of an expert computer system. The first part of this paper demonstrates a methodology for collecting and analyzing observations of experts at work, in order to find the conceptual framework used for the particular domain. The second part develops a representation for qualitative knowledge of the structure and behavior of a mechanism. The qualitative simulation, or envisionment, process is given a qualitative structural description of a mechanism and some initialization information, and produces a detailed description of the mechanism's behavior. The simulation process has been fully implemented, and its results are shown for a particular disease mechanisms in nephrology. This vertical slice of the construction of a cognitive model demonstrates an effective knowledge acquisition method for the purpose of determining the structure of the representation itself, not simply the content of the knowledge to be encoded in that representation. Most importantly, it demonstrates the interaction among constraints derived from the textbook knowledge of the domain, from observations of the human expert, and from the computational requirements of successful performance.