A probabilistic network for the diagnosis of acute cardiopulmonary diseases

In this paper, the development of a probabilistic network for the diagnosis of acute cardiopulmonary diseases is presented in detail. A panel of expert physicians collaborated to specify the qualitative part, which is a directed acyclic graph defining a factorization of the joint probability distribution of domain variables into univariate conditional distributions. The quantitative part, which is a set of parametric models defining these univariate conditional distributions, was estimated following the Bayesian paradigm. In particular, we exploited an original reparameterization of Beta and categorical logistic regression models to elicit the joint prior distribution of parameters from medical experts, and updated it by conditioning on a dataset of hospital records via Markov chain Monte Carlo simulation. Refinement was iteratively performed until the probabilistic network provided satisfactory concordance index values for several acute diseases and reasonable diagnosis for six fictitious patient cases. The probabilistic network can be employed to perform medical diagnosis on a total of 63 diseases (38 acute and 25 chronic) on the basis of up to 167 patient findings.

[1]  Luca Antiga,et al.  Bayes pulmonary embolism assisted diagnosis: a new expert system for clinical use , 2007, Emergency Medicine Journal.

[2]  José Mira Mira,et al.  NasoNet, modeling the spread of nasopharyngeal cancer with networks of probabilistic events in discrete time , 2002, Artif. Intell. Medicine.

[3]  Steen Andreassen,et al.  The TREAT project: decision support and prediction using causal probabilistic networks. , 2007, International journal of antimicrobial agents.

[4]  Adrian Raftery,et al.  The Number of Iterations, Convergence Diagnostics and Generic Metropolis Algorithms , 1995 .

[5]  P. McCullagh,et al.  Generalized Linear Models , 1984 .

[6]  R. L. Winkler The Assessment of Prior Distributions in Bayesian Analysis , 1967 .

[7]  S. Ferrari,et al.  Beta Regression for Modelling Rates and Proportions , 2004 .

[8]  D. Heckerman,et al.  Probabilistic diagnosis using a reformulation of the INTERNIST-1/QMR knowledge base. II. Evaluation of diagnostic performance. , 1991, Methods of information in medicine.

[9]  Nir Friedman,et al.  Probabilistic Graphical Models - Principles and Techniques , 2009 .

[10]  Martyn Plummer,et al.  JAGS: A program for analysis of Bayesian graphical models using Gibbs sampling , 2003 .

[11]  Trivellore E Raghunathan,et al.  What do we do with missing data? Some options for analysis of incomplete data. , 2004, Annual review of public health.

[12]  Marek J. Druzdzel,et al.  SMILE: Structural Modeling, Inference, and Learning Engine and GeNIE: A Development Environment for Graphical Decision-Theoretic Models , 1999, AAAI/IAAI.

[13]  Philip Heidelberger,et al.  Simulation Run Length Control in the Presence of an Initial Transient , 1983, Oper. Res..

[14]  L. C. van der Gaag,et al.  Building probabilistic networks: Where do the numbers come from? - a guide to the literature , 2000 .

[15]  James M. Rippe,et al.  Irwin and Rippe's intensive care medicine , 2003 .

[16]  Carmen Lacave,et al.  Knowledge Acquisition in PROSTANET - A Bayesian Network for Diagnosing Prostate Cancer , 2003, KES.

[17]  Ewart R. Carson,et al.  A Model-Based Approach to Insulin Adjustment , 1991, AIME.

[18]  S Andreassen,et al.  The EMG diagnosis--an interpretation based on partial information. , 1999, Medical engineering & physics.

[19]  J. Pearl Causality: Models, Reasoning and Inference , 2000 .

[20]  Kevin B. Korb,et al.  Bayesian Artificial Intelligence , 2004, Computer science and data analysis series.

[21]  Wray L. Buntine Operations for Learning with Graphical Models , 1994, J. Artif. Intell. Res..

[22]  Peter J. F. Lucas,et al.  A dynamic Bayesian network for diagnosing ventilator-associated pneumonia in ICU patients , 2009, Expert Syst. Appl..

[23]  Marek J. Druzdzel,et al.  Building Probabilistic Networks: "Where Do the Numbers Come From?" Guest Editors Introduction , 2000, IEEE Trans. Knowl. Data Eng..

[24]  David S. Jacobs,et al.  Jacobs & DeMott laboratory test handbook , 2001 .

[25]  A. Detsky,et al.  Evidence-based medicine. A new approach to teaching the practice of medicine. , 1992, JAMA.

[26]  Elizabeth C. Hirschman,et al.  Judgment under Uncertainty: Heuristics and Biases , 1974, Science.

[27]  Silja Renooij,et al.  Probabilities for a probabilistic network: a case study in oesophageal cancer , 2002, Artif. Intell. Medicine.

[28]  Davide Luciani,et al.  Automated interviews on clinical case reports to elicit directed acyclic graphs , 2012, Artif. Intell. Medicine.

[29]  Marek J Druzdzel,et al.  Support of diagnosis of liver disorders based on a causal Bayesian network model. , 2001, Medical science monitor : international medical journal of experimental and clinical research.

[30]  José Mira Mira,et al.  DIAVAL, a Bayesian expert system for echocardiography , 1997, Artif. Intell. Medicine.

[31]  M. Moia,et al.  Differential diagnosis of pulmonary embolism in outpatients with non-specific cardiopulmonary symptoms , 2013, Internal and Emergency Medicine.

[32]  Paul Gustafson,et al.  Bayesian Inference for Partially Identified Models: Exploring the Limits of Limited Data , 2015 .

[33]  B. Nathwani,et al.  Evaluation of an expert system on lymph node pathology. , 1997, Human pathology.

[34]  Christopher Kabrhel,et al.  Derivation and validation of a Bayesian network to predict pretest probability of venous thromboembolism. , 2004, Annals of emergency medicine.

[35]  N. Obuchowski,et al.  Assessing the Performance of Prediction Models: A Framework for Traditional and Novel Measures , 2010, Epidemiology.

[36]  L. C. van der Gaag,et al.  Probabilities for a Probabilistic Network : A Case-study in Oesophageal Carcinoma , 2001 .

[37]  Peter J. F. Lucas,et al.  Bayesian networks in biomedicine and health-care , 2004, Artif. Intell. Medicine.

[38]  Jim Q. Smith,et al.  On the Geometry of Bayesian Graphical Models with Hidden Variables , 1998, UAI.

[39]  Changhe Yuan,et al.  Importance sampling algorithms for Bayesian networks: Principles and performance , 2006, Math. Comput. Model..