Designing for Explanation in Health Care Applications of Expert Systems

A great deal has been written about the role of clinical decision support systems in medicine in recent years—an important category of which are expert systems. Expert systems would normally contain an explanation module—the subject of a great deal of research interest in the 1980s when the main problem-solving task for medical expert systems was diagnostics. However, expert systems nowadays are more likely to perform tasks other than diagnosis, yet the role of explanation in expert systems has been largely ignored in the health care literature since this time. Furthermore, user requirements can vary considerably in the health care domain and may include physicians, medical researchers, administrators, and patients. Such user groups would have differing levels of knowledge and goals, which would impact on the type of explanatory support provided by the system. This article examines the potential benefits of explanation facilities for a range of clinical tasks and also considers the ways in which explanation facilities may be delivered so as to be of benefit to these categories of health care user for these tasks.