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A Probabilistic Network for Fusion of Data and Knowledge in Clinical Microbiology

  • Steen Andreassen
  • Leonard Leibovici
  • Mical Paul
  • Anders D. Nielsen
  • Alina Zalounina
  • Leif E. Kristensen
  • Karsten Falborg
  • Brian Kristensen
  • Uwe Frank
  • Henrik C. Schønheyder
Part of the Advanced Information and Knowledge Processing book series (AI&KP)

Summary

A problem in clinical microbiology is that of inappropriate antibiotic therapy. Various decision-support systems have been proposed to aid physicians in this domain, and we discuss the a priori advantages of using a probabilistic network over other approaches. The Treat project uses a probabilistic network to combine clinical signs, symptoms and laboratory results, and we discuss the problem of obtaining probabilities for the network. Finally, we consider how such a system can be tested in clinical practice and outline the results of our tests.

Keywords

Conditional Probability Antibiotic Therapy Clinical Microbiology Current Clinical Practice Treat Project 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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References

  1. [1]
    S. Andreassen, L. Leibovici, H.C. Schønheyder, B. Kristensen, C. Riekehr, A.G. Kjær, and K.G. Olesen. A decision theoretic approach to empirical treatment of bacteraemia originating from the urinary tract. In W. Horn, editor, Lecture Notes in Artificial Intelligence, Vol. 1620, pages 197–206. Springer-Verlag, Berlin, 1999.Google Scholar
  2. [2]
    S. Andreassen, C. Riekehr, B. Kristensen, H.C. Schønheyder, and L. Leibovici. Using probabilistic and decision-theoretic methods in treatment and prognosis modeling. Artificial Intelligence in Medicine, 15:121–134, 1999.CrossRefGoogle Scholar
  3. [3]
    D.C. Angus, W.T. Linde-Zwirble, J. Lidicker, G. Clermont, J. Carcillo, and M.R. Pinsky. Epidemiology of severe sepsis in the United States: analysis of incidence, outcome, and associated costs of care. Critical Care Medicine, 29:1303–1310, 2001.CrossRefGoogle Scholar
  4. [4]
    Hugin Expert (anonymous). Hugin System Introduction, version 5.1. Hugin Expert A/S, Aalborg, 1997.Google Scholar
  5. [5]
    R.C. Bone. Toward a theory regarding the pathogenesis of the systemic inflammatory response syndrome: What we do and do not know about cytokine regulation. Critical Care Medicine, 24:163–172, 1996.CrossRefGoogle Scholar
  6. [6]
    R.O. Duda and P.E. Hart. Pattern Classification and Scene Analysis. Wiley, New York, 1973.zbMATHGoogle Scholar
  7. [7]
    C.P. Friedman and J.C. Wyatt. Evaluation Methods in Medical Informatics. Computers and Medicine. Springer-Verlag, New York, 1998.Google Scholar
  8. [8]
    B. Kristensen, S. Larsen, H.C. Schønheyder, L. Leibovici, M. Paul, U. Frank, and S. Andreassen. A decision support system (DSS) for antibiotic treatment improves empirical treatment and reduces costs. In Proceedings of 41st Interscience Conference on Antimicrobial Agents and Chemotherapy (ICAAC), page 476, Illinois, 2001. American Society for Microbiology.Google Scholar
  9. [9]
    B. Kristensen, C.H. Riekehr, H.C. Schønheyder, S. Larsen, J. Klitgaard, A. Zalounina, L. Leibovici, U. Frank, and S. Andreassen. Empirical antibiotic treatment of bacteraemia: Evaluation of a Bayesian decision model against clinical practice and guidelines. (Submitted), 2004.Google Scholar
  10. [10]
    S.L. Lauritzen and D.J. Spiegelhalter. Local computation with probabilities on graphical structures and their application to expert systems (with discussion). Journal of the Royal Statistical Society, Series B, 50(2):157–224, 1988.MathSciNetzbMATHGoogle Scholar
  11. [11]
    L. Leibovici, M. Fishman, H.C. Schønheyder, C. Riekehr, B. Kristensen, I. Shraga, and S. Andreassen. A causal probabilistic network for optimal treatment of bacterial infections. IEEE Transactions on Knowledge and Data Engineering, 12(4):517–528, 2000.CrossRefGoogle Scholar
  12. [12]
    L. Leibovici, V. Gitelman, Y. Yehezkelly, O. Poznanski, G. Milo, M. Paul, and P. Ein-Dor. Improving empirical antibiotic treatment: Prospective, non-intervention testing of a decision support system. Journal of Internal Medicine, 242:395–400, 1997.CrossRefGoogle Scholar
  13. [13]
    L. Leibovici, Z. Samra, H. Konigsberger, M. Drucker, S. Ashkenazi, and S.D. Pitlik. Long-term survival following bacteraemia or fungemia. Journal of the American Medical Association, 274:807–812, 1995.CrossRefGoogle Scholar
  14. [14]
    L. Leibovici, I. Shraga, and S. Andreassen. How do you choose antibiotic treatment? British Medical Journal, 318:1614–1616, 1999.Google Scholar
  15. [15]
    T.R. Maschoreck, M.C. Sørensen, M. Andresen, I.M. Høgsberg, P. Rasmussen, and J. Søgård. Omkostningsanalyse af dialysebehandlingen på Odense Universitetshospital og Sønderborg Sygehus. Ugeskr Læger, 160:7418–7424, 1998.Google Scholar
  16. [16]
    J. Pearl. Probabilistic Reasoning in Intelligent Systems: Networks of Plausible Reasoning. Morgan Kaufmann, San Mateo, CA, 1988.Google Scholar
  17. [17]
    E. Shortliffe. Computer-Based Medical Consultations: MYCIN. North Holland, New York, 1976.Google Scholar
  18. [18]
    D.J. Spiegelhalter and S.L. Lauritzen. Sequential updating of conditional probabilities on directed graphical structures. Networks, 20:579–605, 1990.MathSciNetzbMATHGoogle Scholar
  19. [19]
    E. Tacconelli, M. Paul, M.A. Cataldo, N. Almanasreh, A. Zalounina, A. Nielsen, S. Andreassen, U. Frank, R. Cauda, and L. Leibovici. A computerized decision support system (TREAT) to reduce inappropriate antibiotic therapy of bacterial infection. Proceedings at 14th European Congress of Clinical Microbiology and Infectious Diseases, 10(3):4 (abstract), 2004.Google Scholar
  20. [20]
    A.P. Wilson, A.J Bint, A.M. Glenny, L. Leibovici, and T.E. Peto. Meta-analysis and systematic review of antibiotic trials. Journal of Hospital Infections, 43:S211–S214, 1999.CrossRefGoogle Scholar

Copyright information

© Springer-Verlag London Limited 2005

Authors and Affiliations

  • Steen Andreassen
    • 1
  • Leonard Leibovici
    • 2
  • Mical Paul
    • 2
  • Anders D. Nielsen
    • 1
  • Alina Zalounina
    • 1
  • Leif E. Kristensen
    • 3
  • Karsten Falborg
    • 3
  • Brian Kristensen
    • 4
  • Uwe Frank
    • 5
  • Henrik C. Schønheyder
    • 6
  1. 1.Center for Model-Based Medical Decision SupportAalborg UniversityAalborg EastDenmark
  2. 2.Department of MedicineBeilinson Campus, Rabin Medical CenterPetah-TiqvaIsrael
  3. 3.Judex DatasystemerAalborgDenmark
  4. 4.Department of Clinical MicrobiologyAarhus University HospitalÅrhusDenmark
  5. 5.Institut für Umweltmedizin und KrankenhaushygieneFreiburg Universiy HospitalFreiburgGermany
  6. 6.Department of Clinical MicrobiologyAalborg HospitalAalborgDenmark

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