Knowledge engineering: a daily activity on a hospital ward

Two common barriers against the development and diffusion of expert systems in medicine are the difficulty of design and the low level of acceptance. An original experience which entails potential solutions of these issues is reported on: the task of knowledge engineering is performed by residents and medical students on a psychiatry ward. They developed a computer program for the psychopharmacological treatment of depression, using a sophisticated knowledge acquisition system, EMYCIN. The knowledge engineering sessions are analysed in detail and a structured method is proposed. A transcript of a sample run of the resulting program is presented along with an evaluation of its performance, acceptance, educational potential, and amount of endeavour required. The impact of the knowledge engineering process itself is then assessed both from the residents and the medical students standpoint. Finally, the possibility of generalizing the experiment is examined.