A semiotic approach to data in medical decision making

Computer-based support for medical decision making has been a subject of many research projects since the earliest days of computers. Although the early expert systems promised to automate medical diagnosis, very few systems were actually utilized in clinical settings. In the last twenty years, the intent to use computers to replace or simulate medical experts has changed to a less ambitious goal of supporting and assisting the medical decision-making process. Recently, the growing availability of electronically stored patient records has provided a new opportunity for the decision support systems to utilize the data mining tools. In all these types of decision support systems, data play a central role. This paper examines three fundamental issues surrounding data: modeling of data as representation of medical concepts, interpretation of data in multiple contexts, and utilization of data in the decision-making process. The paper introduces a semiotic approach to the analysis of the role of data in medical decision making. This approach assumes that the processes of data modeling, collection, storage, processing, and interpretation are components of a larger communication process - the medical decision-making process. Furthermore, the semiotic approach describes the medical decision-making process in a broader context of representation, interpretation, and meaning making in a social context.