ATTENDING: Critiquing a Physician´s Management Plan

The ATTENDING system is designed to critique a physician´s preoperative plan for anesthetic management. In undertaking to critique a physician´s plan, ATTENDING differs from other medical decision making systems, which in effect attempt to tell a physician what to do. ATTENDING´s approach may prove more acceptable clinically, and may avoid certain social, medical, and medicolegal drawbacks. To cri-tique a physician´s plan, ATTENDING must confront three basic problems. 1) It must be able to explore flexibly all possible approaches for a patient´s management. The formalism of an ``augmented decision network´´ allows this. 2) It must be able to assess the relative risks and benefits of alternative approaches intelligently. A heuristic approach to risk analysis is outlined, based on three basic principles which are de-scribed in detail. 3) It must produce a potentially complex analysis which critiques the plan in focused, readable prose. This is facilitated by PROSENET, an approach which allows clean separation between the organization of the content of an analysis and its expression in English prose.