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By Ingalis A.G. (ed.)

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Set B consists of all the literature citations on immune globulin. A. Spooner asking the PubMed program to give us a new set that is the result of combining A and B using the AND operator, we have a new set, C, that contains literature citations on the use of immune globulin in rheumatoid arthritis. When we combine two sets of citations using the AND function of our PubMed program, we are asking the computer to give us all citations that appear in both sets. This corresponds roughly to the English use of the word and.

Once one creates a knowledge base and populates it with some amount of data, the next task is to create a way to maintain it. Since many CDSS begin as funded academic research projects, it is no wonder that development of their knowledge bases often halts after the grant funds cease. Since knowledge base maintenance takes a tremendous amount of time, and since the market for some CDSS is rather small, many CDSS become too expensive to maintain. The knowledge-acquisition bottleneck [40] has been recognized as a problem in CDSS research.

Effects of a pharmacist-­ to-­dose computerized request on promptness of antimicrobial therapy. J Am Med Inform Assoc. 2009;16(1):47–53. M2559. Epub 2008/10/28doi: M2559 [pii].  A history of the INTERNIST-1 and Quick Medical Reference (QMR) computer-­ assisted diagnosis projects, with lessons learned. Yearb Med Inform. 2010:121–36. 24. Elkin PL, Liebow M, Bauer BA, Chaliki S, Wahner-Roedler D, Bundrick J, et al. The introduction of a diagnostic decision support system (DXplain) into the workflow of a teaching hospital service can decrease the cost of service for diagnostically challenging Diagnostic Related Groups (DRGs).

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