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The full implementation of any intelligent system in health care, which is designed for decision support, has several stages, from initial problem identification through development and, finally, cost‐benefit analysis. Central to this is formal objectivist evaluation with its core component of inherent performance of the outputs from these systems. A Medline survey of one type of intelligent system is presented, which demonstrates that this issue is not being addressed adequately. Lack of criteria for dealing with the outputs from these “black box” systems to prescribe adequate levels of inherent performance may be preventing their being accepted by those in the health‐care domain and, thus, their being applied widely in the field.

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