To be fair the performance of rules or Bayesian networks or statistical models wasn't the problem (performance compared to existing practice). DeDombal showed in 1972 that a simple Bayes model was better than most ED physicians in triaging abdominal pain.
The main barrier to scaling was workflow integration due to lack of electronic data, and if it was available, interoperability (as it is today). The other barriers were problems with maintenance and performance monitoring, which are still issues today in healthcare and other industries.
I do agree the 5th Generation project never made sense, but as you point out they had developed hardware to accelerate Prolog and wanted to show it off and overused the tech. Hmmm, sounds familiar...
The paper of Ueda they cite is so lovely to read, full of marvelous ideas:
Ueda K. Logic/Constraint Programming and Concurrency: The hard-won lessons of the Fifth Generation Computer project. Science of Computer Programming. 2018;164:3-17. doi:10.1016/j.scico.2017.06.002 open access: https://linkinghub.elsevier.com/retrieve/pii/S01676423173012...
The main barrier to scaling was workflow integration due to lack of electronic data, and if it was available, interoperability (as it is today). The other barriers were problems with maintenance and performance monitoring, which are still issues today in healthcare and other industries.
I do agree the 5th Generation project never made sense, but as you point out they had developed hardware to accelerate Prolog and wanted to show it off and overused the tech. Hmmm, sounds familiar...