Bulletin Spring‧Summer 1997

highlights of RGC-funded Projects INDUCE36 concerns the decision to induce labour in pregnant patients after 36 weeks of gestation. This artificial initiation of the delivery process is sometimes required when the continuation of the pregnancy could prove more risky, either for the baby or the mother, than delivering the baby. But, the delivery of an immature foetus means significant risk for the baby, and induction under unfavourable circumstances can also result in a caesarean section which is a relatively high-risk procedure for the mother. Induction of labour thus involves careful appraisal of the duration of the pregnancy and its risk factors, and all pointers of maternal or foetal compromise. INDUCE36 can be an important consultative system here. The system was evaluated by the researchers using 30 hypothetical cases of varying difficulty. Its performance was compared with that of six doctors of different ranks (two interns, two registrars, and two senior registrars). Three consultants examined each of the seven sets of recommendations, i.e. of the six doctors and of INDUCE36, withou t knowing which set belonged to whom. INDUCE36 received the highest average score, and proved its usefulness. ESROM (Expert System on Rupture Of Membranes) can be used for the diagnosis and management of ruptured membranes in obstetrics. When foetal membranes break and the amniotic fluid inside the uterus leaks from the cervix, it can be a sign of labour and delivery. But when it occurs before labour, it can be associated with infection of the foetus and be dangerous. If the foetus is very premature, immediate delivery may increase the possibility of mortality and morbidity. It is thus very importan t to maintain the delicate balance between how long the pregnancy should be prolonged and when the baby should be delivered. ESROM has three goals: Diagnosis — to decide whether the membranes are ruptured; Detection of infection — to indicate whether infection of the foetus is present; and Management — to decide whether the foetus should be delivered. ESROM has 43 objects, 61 rules, and 4 fuzzy types (size, well-being, amount, and moisture). The researchers tested the system and verified the knowledge base on 30 hypothetical cases, and the results agreed well with the domain experts. L o o k i ng A h e ad The results obtained by ABVAB are encouraging for the development of other medical expert systems based on Z-III, and the verification method for INDUCE36 introduces a new approach to the evaluation of medical expert systems. The multi-layer structure of ESROM demonstrates a way to handle complicated medical diagnoses and treatments. In collaboration with Prof. Jack Cheng of the Department of Orthopaedics and Traumatology, Prof. Leung is working on another medical expert system for use in spinal orthopaedics. Prof. Leung hopes that, with the rapid increase in the physical memory of the PC, more complex multi-layer expert systems can be developed by Z-III, and expert system applications can be more widely accepted in fields other than medicine. —Medical Decisions Based on Fuzziness and Uncertainty 39