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Evaluation of Fuzzy Relation Method for Medical Decision Support

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Abstract

The potential of computer based tools to assist physicians in medical decision making, was envisaged five decades ago. Apart from factors like usability, integration with work-flow and natural language processing, lack of decision accuracy of the tools has hindered their utility. Hence, research to develop accurate algorithms for medical decision support tools, is required. Pioneering research in last two decades, has demonstrated the utility of fuzzy set theory for medical domain. Recently, Wagholikar and Deshpande proposed a fuzzy relation based method (FR) for medical diagnosis. In their case studies for heart and infectious diseases, the FR method was found to be better than naive bayes (NB). However, the datasets in their studies were small and included only categorical symptoms. Hence, more evaluative studies are required for drawing general conclusions. In the present paper, we compare the classification performance of FR with NB, for a variety of medical datasets. Our results indicate that the FR method is useful for classification problems in the medical domain, and that FR is marginally better than NB. However, the performance of FR is significantly better for datasets having high proportion of unknown attribute values. Such datasets occur in problems involving linguistic information, where FR can be particularly useful. Our empirical study will benefit medical researchers in the choice of algorithms for decision support tools.

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References

  1. Shortliffe, E. H., and Cimino, J. J., Biomedical informatics: Computer applications in health care and biomedicine. Springer, 2006.

  2. Hibble, A., Kanka, D., Pencheon, D., and Pooles, F., Guidelines in general practice: The new tower of babel? Br. Med. J. 317(7162):862–863, 1998.

    Article  Google Scholar 

  3. Jackson, P., Introduction to Expert Systems, 3rd Edn. Addison Wesley, 1998.

  4. Miller, R. A., Medical diagnostic decision support systems—Past, present, and future: A threaded bibliography and brief commentary. J. Am. Med. Inform. Assoc. 1(1):8–27, 1994.

    Article  Google Scholar 

  5. Ledley, R. S., and Lusted, L. B., Reasoning foundations of medical diagnosis; symbolic logic, probability, and value theory aid our understanding of how physicians reason. Science 130(3366):9–21, 1959.

    Article  Google Scholar 

  6. de Dombal, F. T., Leaper, D. J., Staniland, J. R., McCann, A. P., and Horrocks, J. C., Computer-aided diagnosis of acute abdominal pain. Br. Med. J. 2(5804):9–13, 1972.

    Article  Google Scholar 

  7. Shortliffe, E. H., Davis, R., Axline, S. G., Buchanan, B. G., Green, C. C., and Cohen, S. N., Computer-based consultations in clinical therapeutics: Explanation and rule acquisition capabilities of the mycin system. Comput. Biomed. Res. (An International Journal), 8(4):303–320, 1975.

    Article  Google Scholar 

  8. Burnside, E. S., Bayesian networks: Computer-assisted diagnosis support in radiology. Acad. Radiol. 12(4):422–430, 2005.

    Article  Google Scholar 

  9. Sanchez, E., Inverses of fuzzy relations. Application to possibility distributions and medical diagnosis. Fuzzy Sets Syst. 2(1):75–86, 1979.

    Article  MATH  Google Scholar 

  10. Adlassnig, K., The section on medical expert and knowledge-based systems at the Department of Medical Computer Sciences of the University of Vienna Medical School. Artif. Intell. Med. 21(1–3):139–146, 2001.

    Article  Google Scholar 

  11. Ramnarayan, P., Cronje, N., Brown, R., Negusm, R., Coode, B., Moss, P., Hassan, T., Hamer, W., and Britto, J., Validation of a diagnostic reminder system in emergency medicine: A multi-centre study. Emerg. Med. J. 24(9):619–624, 2007.

    Article  Google Scholar 

  12. Cohen, M. E., and Hudson, D. L., Meta neural networks as intelligent agents for diagnosis. In: International Joint Conference on Neural Networks, Vol. 1, pp. 233–238, 2002.

  13. Güler, I., and Ubeyli, E. D., Multiclass support vector machines for eeg-signals classification. IEEE Trans. Inf. Technol. Biomed. 11(2):117–126, 2007.

    Article  Google Scholar 

  14. Liu, J. L., Wyatt, J. C., Deeks, J. J., Clamp, S., Keen, J., Verde, P., Ohmann, C., Wellwood, J., Dawes, M., and Altman, D. G., Systematic reviews of clinical decision tools for acute abdominal pain. Health Technol. Assess. 10(47), 2006.

  15. Adams, I. D., Chan, M., Clifford, P. C., Cooke, W. M., Dallos, V., de Dombal, F. T., Edwards, M. H., Hancock, D. M., Hewett, D. J., and McIntyre, N., Computer aided diagnosis of acute abdominal pain: A multicentre study. Br. Med. J. (Clin. Res. Ed.) 293(6550):800–804, 1986.

    Article  Google Scholar 

  16. Todd, B. S., and Stamper, R., The relative accuracy of a variety of medical diagnostic programs. Methods Inf. Med. 33(4):402–416, 1994.

    Google Scholar 

  17. Ohmann, C., Moustakis, V., Yang, Q., and Lang, K., Evaluation of automatic knowledge acquisition techniques in the diagnosis of acute abdominal pain. Acute abdominal pain study group. Artif. Intell. Med. 8(1):23–36, 1996.

    Article  Google Scholar 

  18. Domingos, P., and Pazzani, M., On the optimality of the simple bayesian classifier under zero-one loss. Mach. Learn. 29(2):103–130, 1997.

    Article  MATH  Google Scholar 

  19. Joly, H., Sanchez, E., Gouvernet, J., and Valty, J., Applications of fuzzy set theory to the evaluation of cardiac function. In: Lindberg, D. A. B., and Kaihara, S. (Eds.), MedInfo’80, pp. 91–95. North Holland Amsterdam, 1980.

  20. Soula, G., Gouvernet, J., Barre, A., and Marco, J. S., Application of fuzzy relations to medical decision making. In: Medinfo 80, 1980.

  21. Esogbue, A. O., and Elder, R. C., Fuzzy sets and the modelling of physician decision processes, part I: The initial interview-information gathering session. Fuzzy Sets Syst. 2(4):279–291, 1979.

    Article  MATH  Google Scholar 

  22. Adlassnig, K. P., Scheithauer, W., and Grabner, G., Computer-assisted diagnosis and its application in pancreatic diseases. Acta Med. Austriaca 11(3–4):125–134, 1984.

    Google Scholar 

  23. Adlassnig, K. P., Kolarz, G., Scheithauer, W., and Grabner, H., Approach to a hospital-based application of a medical expert system. Med. Inform. (Lond.) 11(3):205–223, 1986.

    Article  Google Scholar 

  24. Sageder, B., Boegl, K., Adlassnig, K. P., Kolousek, G., and Trummer, B., The knowledge model of medframe/cadiag-iv. Stud. Health Technol. Inform. 43(Pt B):629–633, 1997.

    Google Scholar 

  25. Nagy, S., Hayde, M., Panzenböck, B., Adlassnig, K. P., and Pollak, A., Toxopert-i: Knowledge-based automatic interpretation of serological tests for toxoplasmosis. Comput. Methods Programs Biomed. 53(2):119–133, 1997.

    Article  Google Scholar 

  26. Yen, G. G., and Meesad, P., Constructing a fuzzy rule-based system using the ilfn network and genetic algorithm. Int. J. Neural Syst. 11(5):427–443, 2001.

    Google Scholar 

  27. Tsipouras, M. G., Voglis, C., and Fotiadis, D. I., A framework for fuzzy expert system creation—Application to cardiovascular diseases. IEEE Trans. Biomed. Eng. 54(11):2089–2105, 2007.

    Article  Google Scholar 

  28. Krajnak, M., and Xue, J., Optimizing fuzzy clinical decision support rules using genetic algorithms. In: International Conference of IEEE Engineering in Medicine and Biology Society, Vol. 1, pp. 5173–5176. GE Healthcare Information Technology: Milwaukee, WI 53226, USA, 2006.

    Chapter  Google Scholar 

  29. Wagholikar, K. B., and Deshpande, A. W., Fuzzy relation based modeling for medical diagnostic decision support: Case studies. Int. J. Knowl.-Based Intel. Eng. Syst. 12(5,6):319–326, 2008.

    Google Scholar 

  30. Kohavi, R., Becker, B., and Sommerfield, D., Improving simple bayes. In: The Ninth European Conference on Machine Learning. Springer-Verlag: New York, 1997.

    Google Scholar 

  31. Adlassnig, K. P., and Kolarz, G., Representation and semiautomatic acquisition of medical knowledge in cadiag-1 and cadiag-2. Comput. Biomed. Res. 19(1):63–79, 1986.

    Article  Google Scholar 

  32. Hand, D. J., and Till, R. J., A simple generalisation of the area under the roc curve for multiple class classification problems. Mach. Learn. 45(2):171–186, 2001.

    Article  MATH  Google Scholar 

  33. Asuncion, A., and Newman, D. J., UCI Machine Learning Repository, 2007.

  34. Yeh, I.-C., Yang, K.-J., and Ting, T.-M., Knowledge discovery on rfm model using bernoulli sequence. Expert Syst. Appl. 36(3):5866–5871, 2009.

    Article  Google Scholar 

  35. Street, W. N., Wolberg, W. H., and Mangasaria, O. L., Nuclear feature extraction for breast tumor diagnosis. In: International Symposium on Electronic Imaging: Science and Technology, Vol. 1905, pp. 861–870, 1993.

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Acknowledgements

We thank Dr. Bryan Todd, for contributing the gynaecology dataset, and UCI administrators for maintaining the UCI datasets. We are grateful to Dr. S.R. Gadre for making computational facilities available for this work and to the reviewers for their excellent suggestions.

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Correspondence to Kavishwar Wagholikar.

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Wagholikar, K., Mangrulkar, S., Deshpande, A. et al. Evaluation of Fuzzy Relation Method for Medical Decision Support. J Med Syst 36, 233–239 (2012). https://doi.org/10.1007/s10916-010-9472-5

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  • DOI: https://doi.org/10.1007/s10916-010-9472-5

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