Introduction Decision-making in healthcare is a knowledge-intensive activity that may surpass the ability of the human cognitive processing.

In their seminal work from the seventies (Pauker et al., 1976), assert that clinicians make clinical decisions on guesses of initial hypotheses, which are based on minimal amounts of data. Factors that contribute to patient outcomes can be related to: -> specific patient characteristics -> external forces (e.g. facility ownership, reimbursement patterns, and regulatory agencies) -> internal forces (e.g. case-mix and staffing ratios) The term data mining is often misperceived. Commonly associated with fishing and dredging, many in the past have chosen to avoid exploration of this technique. It is important to emphasize that the tools of KDD are totally independent from the data on which they operate. Therefore, KDD utility is domainindependent and can be used in any large collection of data. The value of KDD as an approach is often confused with the character of the data, which in healthcare has a tendency to be noisy or dirty. Innovative Approaches to Information Management in Healthcare The move toward integrated health systems and the tracking of data from cradle to grave has highlighted the need for a method by which the vast amounts of data being collected can be analyzed and visualized. The problem arises in the intensive multidimensionality, fragmentation, and distribution of healthcare data that can overload human cognitive capacity as well as traditional methods of aggregation and analysis. Knowledge Discovery in Large Data Sets KDD as the melding of human expertise with statistical and machine learning techniques to identify features, patterns, and underlying rules in large collections of healthcare data. Abbott (2000) KDD as the non-trivial process of identifying valid, novel, potentially useful, and ultimately understandable patterns in data. Fayyad et al., 1989 Data mining and KDD in healthcare uses a combination of artificial intelligence (AI) and computer science techniques to help build knowledge in complex healthcare domains. Goodwin et al., 1997

In essence, KDD can be viewed as extracting high-level knowledge from low-level data. Fayyad et al., 1989 The techniques used in KDD and data mining are NOT NEW, having been discovered in the field of AI research in 1980s. Differentiation of Verification versus Discovery Approaches Current statistical models based on regression offer the possibility of indepth analysis but may require unrealistic assumptions about the distribution and interdependence of data/errors. Traditional analysis supports a verification-based approach to hypothesis testing. A specific hypothesis is made, variables suspected to be contributors of the phenomenon of study are isolated, and analytic tools are used to either refute or prove the original postulate. The effectiveness of this approach can be limited by a variety of issues including the knowledge base of the investigator, the ability of the investigator to detect trends in the data and to pose proper questions, the ability to compose the complex queries required, the character and quality of multivariate data, and the ability to work with constrained or artificially imposed constructs. In contrast, KDD is based on discovery-driven approaches to hypothesis testing, where the unexpected is valued. This technique can be used to sift through large repositories to discover trends, predictive patterns, or correlations in data; confirm hypotheses; and highlight exceptions. The two primary goals of KDD: Description deals with the discovery of patterns interpretable by humans, which are used to describe the data. Prediction focuses on using variables within the data set to predict future/unknown values of other variables in interest.