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Safe and Sound: Artificial Intelligence in Hazardous Applications. John Fox and Subrata Das. Menlo Park, CA: AAAI Press/MIT Press, 2000, 325 pp., $40.00. ISBN 0-262-06211-9.

¹ Baylor College of Medicine Houston, TX 77030

This curiously titled book tries to address several important topics in the application of artificial intelligence methods to medical decision making. It succeeds only where it presents a knowledge representation model and derived system that are highly technical, clearly the area of expertise of the authors.

The volume contains three sections. The first, "Cognitive Science to Cognitive Engineering", begins with a general review of computer applications in medicine, mentions classic work in passing, and illustrates the role of uncertainty in medical decision making. This section ends with a description of the authors’ method for knowledge-based system construction, PROforma. The historical review offers weak motivation for the methodology, and on its own does not offer anything new relative to standard current texts and reviews in medical artificial intelligence.

The second section, "A Duty of Care", introduces the topic of safety in systems development. Fox and Das are very interested in the risks of agent technologies, in which expert systems are built that act autonomously (that is, by the use of computerized agents). Several prominent medical systems feature unassisted decision making, something that concerns leaders in the field. The authors describe agents well and develop a conceptually pleasing logical model of a "safety agent" that can be built within a decision-making system to assess the risks of decisions and alert users to the possibility of adverse events.

In the third section, "Rigorously Engineered Decisions", the authors develop their knowledge representation language (RED) and apply it to two examples drawn from the diagnosis of suspected gastric cancer and the management of asthma. RED and its implementation R2L are hybrid rule- and knowledge-based languages that explicitly represent evidence for assertions and use classic logic to form rules. RED seems to descend from the PROLOG family of languages and is well adapted to the creation of expert systems for medicine. It handles time naturally, as descriptors and properties. The concept of safety is explicitly encoded by terms in the language that define risk, the notion of a "safe" action, and actions such as obligation, permission, and review. A well-designed graphical user interface is presented for system implementation. The examples are rudimentary and designed to show the system concepts rather than mastery of a complete problem space.

Safe and Sound is not a book for the casual reader or the beginning student of knowledge-based systems in medicine. System developers and medical computer scientists will find some ideas of interest here, particularly the way the authors address safety in agent systems directly. Further development of the representation language and a comprehensive application will be necessary to broaden the appeal of this text.

This Article Extract Full Text (PDF) Submit an electronic Letter to the Editor about this paper Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Beck, J. R. Search for Related Content PubMed Articles by Beck, J. R.