Encoding Clinical Recommendations into Fuzzy DSSs: An Application to COPD Guidelines

Clinical Decision Support Systems (DSSs) have been applied to medical scenarios by computerizing a set of clinical guidelines of interest, with the final aim of simulating the process followed by the physicians. In this context, fuzzy logic has been profitably used for modeling clinical guidelines affected by uncertainty and improving the interpretability of clinical DSSs through its expressivity close to natural language. However, the task of computerizing clinical guidelines in terms of fuzzy if-then rules can be complex and, often, requires technical capabilities not owned by physicians. In order to face this issue, this paper introduces a fuzzy knowledge editing framework expressly devised and designed to simplify the procedures necessary to codify clinical guidelines in terms of fuzzy if-then rules and linguistic variables. This framework is described with respect to a specific real case regarding the formalization of clinical recommendations extracted from the GOLD guidelines, which contain the best evidence for diagnosing and managing the Chronic Obstructive Pulmonary Disease.

[1]  Berend Jan van der Zwaag,et al.  Fuzzy logic in clinical practice decision support systems , 2000, Proceedings of the 33rd Annual Hawaii International Conference on System Sciences.

[2]  Rainu Kaushal,et al.  Bmc Medical Informatics and Decision Making Assessing the Level of Healthcare Information Technology Adoption in the United States: a Snapshot , 2005 .

[3]  Giuseppe De Pietro,et al.  A Fuzzy Decision Support Language for Building Mobile DSSs for Healthcare Applications , 2012, MobiHealth.

[4]  José M. Alonso,et al.  KBCT: a knowledge extraction and representation tool for fuzzy logic based systems , 2004, 2004 IEEE International Conference on Fuzzy Systems (IEEE Cat. No.04CH37542).

[5]  I. Scott,et al.  What are the most effective strategies for improving quality and safety of health care? , 2009, Internal medicine journal.

[6]  Douglas G. Altman,et al.  BMC Medical Informatics and Decision Making , 2005 .

[7]  Chris Tseng,et al.  Universal fuzzy system representation with XML , 2005, Comput. Stand. Interfaces.

[8]  Richard N. Shiffman,et al.  Model Formulation: Representation of Clinical Practice Guidelines in Conventional and Augmented Decision Tables , 1997, J. Am. Medical Informatics Assoc..

[9]  J. Wenny Rahayu,et al.  Archetype sub-ontology: Improving constraint-based clinical knowledge model in electronic health records , 2012, Knowl. Based Syst..

[10]  Iluminada Baturone,et al.  Xfuzzy 3.0: a development environment for fuzzy systems , 2001, EUSFLAT Conf..

[11]  Giovanni Acampora,et al.  Fuzzy Markup Language: A new solution for transparent intelligent agents , 2011, 2011 IEEE Symposium on Intelligent Agent (IA).

[12]  Oliver Thomas,et al.  Fuzzy-EPC Markup Language: XML Based Interchange Formats for Fuzzy Process Models , 2010, Soft Computing in XML Data Management.

[13]  Moshe Sipper,et al.  A fuzzy-genetic approach to breast cancer diagnosis , 1999, Artif. Intell. Medicine.

[14]  Raja Noor Ainon,et al.  Design of a Fuzzy-based Decision Support System for Coronary Heart Disease Diagnosis , 2012, Journal of Medical Systems.

[15]  Matteo Gaeta,et al.  A knowledge-based framework for emergency DSS , 2011, Knowl. Based Syst..

[16]  Lotfi A. Zadeh,et al.  A Theory of Approximate Reasoning , 1979 .

[17]  Brigitte Charnomordic,et al.  Learning interpretable fuzzy inference systems with FisPro , 2011, Inf. Sci..