Integration of quantitative and qualitative reasoning: an expert system for cardiosurgical patients

In this work the possibility of building an expert system to reason on the status of post-operative cardiac patients in intensive care units is analysed. The long-term knowledge consists of causal network which describes the main relationships between hemodynamic and metabolic quantities involved in the evolution after cardiac surgery. The inference engine uses an original hybrid formalism, which integrates numerical simulation and qualitative methods. If available, the numerical values of quantities and their exact mathematical relationships are employed; otherwise, the inference engine reasons by using a discrete qualitative representation of quantities. Simulations performed using real data indicate that integration of quantitative and qualitative methods reduces the number of diagnostic scenarios compatible with patient data, and constitutes a valid tool for reasoning about physiological disorders in terms of deep causal knowledge.

[1]  W. Knaus,et al.  A COMPARISON OF INTENSIVE CARE IN THE U.S.A. AND FRANCE , 1982, The Lancet.

[2]  Arthur C. Guyton,et al.  Circulatory physiology : cardiac output and its regulation , 1965 .

[3]  S Uckun Model-based reasoning in biomedicine. , 1992, Critical reviews in biomedical engineering.

[4]  Guido Avanzolini,et al.  Qualitative simulation of dynamic physiological models using the KEE environment , 1992, Artif. Intell. Medicine.

[5]  L E Widman,et al.  Expert system reasoning about dynamic systems by semi-quantitative simulation. , 1989, Computer methods and programs in biomedicine.

[6]  François E. Cellier General system problem solving paradigm for qualitative modeling , 1991 .

[7]  Kees de Koning,et al.  Qualitative reasoning: Modeling and simulation with incomplete knowledge , 1996 .

[8]  Benjamin Kuipers,et al.  Qualitative reasoning: Modeling and simulation with incomplete knowledge , 1994, Autom..

[9]  D. E. Lawrence,et al.  APACHE—acute physiology and chronic health evaluation: a physiologically based classification system , 1981, Critical care medicine.

[10]  Arthur Selzer,et al.  CIRCULATORY PHYSIOLOGY: Cardiac Output and Its Regulation , 1964 .

[11]  W. Long,et al.  REASONING ABOUT THERAPY FROM A PHYSIOLOGICAL MODEL , 1986 .

[12]  G Avanzolini,et al.  Unsupervised learning and discriminant analysis applied to identification of high risk postoperative cardiac patients. , 1990, International journal of bio-medical computing.

[13]  G Avanzolini,et al.  Variable selection for the classification of postoperative cardiac patients. , 1991, International journal of bio-medical computing.