A Qualitative Expert System for Clinical Trial Assignment

Assigning patients into clinical trials is a knowledge and data intensive task. Determining the eligibility of a patient for admission int.o a clioical trial is based 1,port specific criteria. These criteria may be shared among several prul.ocols or may be ,nique to one protocol. A major diffic,lty in assigning patients to clinical trial protocols is the absence of complete iz, formation regarding the patient. Much of the needed data can be tin,econsuming or expensive to obiaht, or needed tests can cause pa~n or cliscomh)rt to |,]LC pal.ienl. Another difficulty is that there are m;tny open Lrials at an institution at any one lime and il is w.ry difficuh to keep track of criteria fi~r each trial. Ttlis paper investigates the use of a fuzzy expert, system joined with a depemiency analysis to handle uncertainty and sort needed data for several protocols in order o|" influeuce. The system’s outpu! is an ev’,duation of the patient’s eligibility tot one or more clinical trials. Preliminary tests show that the system presents important data as high priority data while finding an appropriate order to obta.in all needed data. We have imple-leltted four breast cancer protocols and successfully tested 15 cases which were clinically eligible for one of the four protocols.