What conceptual evolution replaced mimicking an expert's memorized rules in later CDSS design?

Answer

Actively synthesizing the latest published research via Evidence-Based Medicine (EBM)

The conceptual leap occurring in the 1990s involved transitioning the primary mechanism of decision support from static, encoded knowledge to dynamic utilization of current medical evidence. Earlier systems were built to mimic the memorized rules and patterns of a single human expert. In contrast, the evolution toward Evidence-Based Medicine (EBM) meant the goal became actively synthesizing and applying the continually emerging body of published research. This shift allowed modern systems to adapt more fluidly to new medical findings without requiring the extensive, manual reprogramming that afflicted the symbolic rule-based systems of the previous decades, allowing them to learn from aggregated patient outcomes.

What conceptual evolution replaced mimicking an expert's memorized rules in later CDSS design?

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