Reasoning from the clinical literature: a "distance" metric

There has been little or no integration of specific studies from the clinical literature with computer-based medical advice systems. This paper reports preliminary results of a research project designed to model reasoning from the clinical literature. The program, named "Roundsman", draws upon structured representations of the clinical literature in order to critique plans for medical management. This paper discusses the need for a clinical "distance" metric to use in mapping from studies to treatment choices. The design of one such metric is outlined, and the results of its incorporation in Roundsman are shown in a sample output from the program. The application domain for this program is the management of primary breast cancer, but the research goals are to identify general issues which arise in diverse medical management domains.