Exam: Final 1
                              
            (Introduction to Medical Informatics)
         (http://www.cpmc.columbia.edu/edu/textbook)

1. What is the purpose of the HL7 data standard?

2. Why are sensitivity and specificity considered a better
     measure of a test's performance than accuracy
     (TP+TN/total)?

3. A 50 year old woman is considering elective
     cholecystectomy (remove the gall bladder). If she has
     elective surgery, then there is a 4% chance that she
     will die due to surgery. If she survives surgery, then
     she will lead a healthy life and her gall bladder
     cannot become infected. If she does not have elective
     surgery, then there is a 20% chance that her gall
     bladder will become infected, requiring emergency
     surgery. With emergency surgery, there is a 30% chance
     of dying. Assume that if she survives, then she will
     lead a healthy life. Draw the decision tree for this
     situation, and calculate the utility. Should she have
     the elective surgery? (Hint: since it is assumed that
     when she survives she is healthy, the utility for
     surviving can be set to 1.)

4. Compare a rule-based expert system (eg, MYCIN) to a
     probability-based system (including quasi-probability
     like QMR) for doing diagnosis in medicine. What are the
     relative advantages and disadvantages of each?

5. What are the obstacles to sharing electronic medical
     knowledge bases?

6. The separation of domain knowledge from problem-solving
     knowledge achieves what goal(s)?

7. What are the advantages of computer-aided instruction
     over traditional lecture-style instruction in medical
     education?

8. Why do clinical information systems in modern hospitals
     and office practices look so backward compared to what
     is available in a computer science department?

9. What is a "gold standard" in evaluation? What can be done
     if one does not exist?

10. What are the major functions performed by health-
     assessment information systems (what are they used
     for)?