This article presents a framework and case study of knowledge revision and maintenance. Doing so it relies on a real-world application of medical decision making, namely, acute abdominal pain in children (AAPC), and makes use of an integrated learning and knowledge revision system called MOBAL. The presented framework integrates expert knowledge with empirical knowledge. MOBAL serves as a vehicle of interaction between the expert user and the medical records, which brings empirical knowledge into the process. An iterative-cyclic framework is used to formalize knowledge revision and maintenance. Results are demonstrated using AAPC. The article focuses on expert user-revision system interaction while it offers a complete case study account of using MOBAL in a real-world setting.