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50 Years of Informatics Research on Decision Support: What’s Next

Journal: Methods of Information in Medicine
Subtitle: A journal stressing, for more than 50 years, the methodology and scientific fundamentals of organizing, representing and analyzing data, information and knowledge in biomedicine and health care
ISSN: 0026-1270
DOI: http://dx.doi.org/10.3414/ME11-06-0004
Issue: 2011 (Vol. 50): Issue 6 2011
Pages: 525-535

50 Years of Informatics Research on Decision Support: What’s Next

J. A. Mitchell (1), U. Gerdin (2), D. A. B. Lindberg (3), C. Lovis (4), F. J. Martin-Sanchez (5), R. A. Miller (6), E. H. Shortliffe (7), T.-Y. Leong (8)

(1) The University of Utah, Salt Lake City, UT, USA; (2) National Board of Health and Welfare, Regulations and Licenses, Terminology, Classifications and Informatics, Stockholm, Sweden; (3) National Library of Medicine, Bethesda, MD, USA; (4) University Hospitals of Geneva, Geneva, Switzerland; (5) The University of Melbourne, Melbourne, Victoria, Australia; (6) Vanderbilt University Medical Center, Nashville, TN, USA; (7) The University of Texas Health Science Center at Houston, TX, USA; (8) National University of Singapore, Singapore


Knowledge Representation, Information Retrieval, Education, personalized medicine, Decision support; standard vocabularies, genomic and clinical information, integrative system


Objectives: To reflect on the history, status, and future trends of decision support in health and biomedical informatics. To highlight the new challenges posed by the complexity and diversity of genomic and clinical domains. To examine the emerging paradigms for supporting cost-effective, personalized decision making. Methods: A group of international experts in health and biomedical informatics presented their views and discussed the challenges and issues on decision support at the Methods of Information in Medicine 50th anniversary symposium. The experts were invited to write short articles summarizing their thoughts and positions after the symposium. Results and Conclusions: The challenges posed by the complexity and diversity of the domain knowledge, system infrastructure, and usage pattern are highlighted. New requirements and computational paradigms for representing, using, and acquiring biomedical knowledge and healthcare protocols are proposed. The underlying common themes identified for developing next-generation decision support include incorporating lessons from history, uniform vocabularies, integrative interfaces, contextualized decisions, personalized recommendations, and adaptive solutions.

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