In addition to the diagnostic expert systems for hospital infection control just outlined, there are two other projects developing systems in the domain of biosurveillance. Shannon and colleagues at the Children's Hospital in Boston are developing a web-based diagnostic expert system to assist emergency room clinicians with diagnosis of approximately 20 diseases caused by biological agents known to have been weaponized or that are otherwise of concern as potential bioterrorist threats. The system has developed and evaluated on-line educational modules about the biological agents (Chung et al., 2004), and is intended to support the reporting of cases to local, state, and federal agencies (Shannon et al., 2002). Similar to stand-alone expert systems, the web-based tool requires clinicians to manually enter patient information.
The National Library of Medicine has developed a system called WISER (Wireless Information System for Emergency Responders) to assist first responders when they arrive at a hazardous material (Hazmat) incident, such as a chemical spill (http://wiser.nlm.nih.gov/). WISER operates on a personal digital assistant (PDA) and can send and receive data with a central location and other PDAs running the WISER program through a wireless network. WISER contains a diagnostic expert system that provides assistance in identification of an unknown substance and, once the substance is identified, provides guidance on actions to save lives and protect the environment. The WISER framework could be expanded to include a diagnostic expert system for the analysis of patient or animal findings.
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