Synergistic case-based reasoning in medical domains

This paper presents four synergistic systems that exemplify the approaches and benefits of case-based reasoning in medical domains. It then explores how these systems couple Artificial Intelligence (AI) research with medical research and practice, integrate multiple AI and computing methodologies, leverage small numbers of available cases, reason with time series data, and integrate numeric data with contextual and subjective information. The following systems are presented: (1) CARE-PARTNER, which supports the long-term follow-up care of stem-cell transplantation patients; (2) the 4 Diabetes Support System, which aids in managing patients with type 1 diabetes on insulin pump therapy; (3) Retrieval of HEmodialysis in NEphrological Disorders, which supports hemodialysis treatment of patients with end stage renal disease; and (4) the Mälardalen Stress System, which aids in the diagnosis and treatment of stress-related disorders.     

Fuzzy cognitive map architectures for medical decision support systems

Medical decision support systems can provide assistance in crucial clinical judgments, particularly for inexperienced medical professionals. Fuzzy cognitive maps (FCMs) is a soft computing technique for modeling complex systems, which follows an approach similar to human reasoning and the human decision-making process. FCMs can successfully represent knowledge and human experience, introducing concepts to represent the essential elements and the cause and effect relationships among the concepts to model the behavior of any system. Medical decision systems are complex systems that can be decomposed to non-related and related subsystems and elements, where many factors have to be taken into consideration that may be complementary, contradictory, and competitive; these factors influence each other and determine the overall clinical decision with a different degree. Thus, FCMs are suitable for medical decision support systems and appropriate FCM architectures are proposed and developed as well as the corresponding examples from two medical disciplines, i.e. speech and language pathology and obstetrics, are described.     

A connectionist approach for similarity assessment in case-based reasoning systems

Case-Based Reasoning (CBR) systems support ill-structured decision making. In ill-structured decision environments, decision makers (DMs) differ in their problem solving approaches. As a result, CBR systems would be more useful if they were able to adapt to the idiosyncrasies of individual decision makers. Existing implementations of CBR systems have been mainly symbolic, and symbolic CBR systems are unable to adapt to the preferences of decision makers (i.e., they are static). Retrieval of appropriate previous cases is critical to the success of a CBR system. Widely used symbolic retrieval functions, such as nearest-neighbor matching, assume independence of attributes and require specification of their importance for matching. To ameliorate these deficiencies connectionist systems have been proposed. However, these systems are limited in their ability to adapt and grow. To overcome this limitation, we propose a distributed connectionist-symbolic architecture that adapts to the preferences of a decision maker and that, additionally, ameliorates the limitations of symbolic matching. The proposed architecture uses a supervised learning technique to acquire the matching knowledge. The architecture allows the growth of a case base without the involvement of a knowledge engineer. Empirical investigation of the proposed architecture in an ill-structured diagnostic decision environment demonstrated a superior retrieval performance when compared to the nearest-neighbor matching function.     

Developing a diagnostic system through integration of fuzzy case-based reasoning and fuzzy ant colony system

This study intends to propose a hybrid Case-Based Reasoning (CBR) system with the integration of fuzzy sets theory and Ant System-based Clustering Algorithm (ASCA) in order to enhance the accuracy and speed in case matching. The cases in the case base are fuzzified in advance, and then grouped into several clusters by their own similarity with fuzzified ASCA. When a new case occurs, the system will find the closest group for the new case. Then the new case is matched using the fuzzy matching technique only by cases in the closest group. Through these two steps, if the number of cases is very large for the case base, the searching time will be dramatically saved. In the practical application, there is a diagnostic system for vehicle maintaining and repairing, and the results show a dramatic increase in searching efficiency.     

A weight adaptation method for fuzzy cognitive map learning

Fuzzy cognitive maps (FCMs) constitute an attractive modeling approach that encompasses advantageous features. The most pronounces are the flexibility in system design, model and control, the comprehensive operation and the abstractive representation of complex systems. The main deficiencies of FCMs are the critical dependence on the initial experts beliefs, the recalculation of the weights corresponding to each concept every time a new strategy is adopted and the potential convergence to undesired equilibrium states. In order to update the initial knowledge of human experts and to combine the human experts structural knowledge with the training from data, a learning methodology for FCMs is proposed. This learning method, based on nonlinear Hebbian-type learning algorithm, is used to adapt the cause–effect relationships of the FCM model improving the efficiency and robustness of FCMs. A process control problem is presented and its process is investigated using the proposed weight adaptation technique.     

A hybrid case adaptation approach for case-based reasoning

Case-Based Reasoning is a methodology for problem solving based on past experiences. This methodology tries to solve a new problem by retrieving and adapting previously known solutions of similar problems. However, retrieved solutions, in general, require adaptations in order to be applied to new contexts. One of the major challenges in Case-Based Reasoning is the development of an efficient methodology for case adaptation. The most widely used form of adaptation employs hand coded adaptation rules, which demands a significant knowledge acquisition and engineering effort. An alternative to overcome the difficulties associated with the acquisition of knowledge for case adaptation has been the use of hybrid approaches and automatic learning algorithms for the acquisition of the knowledge used for the adaptation. We investigate the use of hybrid approaches for case adaptation employing Machine Learning algorithms. The approaches investigated how to automatically learn adaptation knowledge from a case base and apply it to adapt retrieved solutions. In order to verify the potential of the proposed approaches, they are experimentally compared with individual Machine Learning techniques. The results obtained indicate the potential of these approaches as an efficient approach for acquiring case adaptation knowledge. They show that the combination of Instance-Based Learning and Inductive Learning paradigms and the use of a data set of adaptation patterns yield adaptations of the retrieved solutions with high predictive accuracy.     

Application of probabilistic and fuzzy cognitive approaches in semantic web framework for medical decision support

This study aimed to focus on medical knowledge representation and reasoning using the probabilistic and fuzzy influence processes, implemented in the semantic web, for decision support tasks. Bayesian belief networks (BBNs) and fuzzy cognitive maps (FCMs), as dynamic influence graphs, were applied to handle the task of medical knowledge formalization for decision support. In order to perform reasoning on these knowledge models, a general purpose reasoning engine, EYE, with the necessary plug-ins was developed in the semantic web. The two formal approaches constitute the proposed decision support system (DSS) aiming to recognize the appropriate guidelines of a medical problem, and to propose easily understandable course of actions to guide the practitioners. The urinary tract infection (UTI) problem was selected as the proof-of-concept example to examine the proposed formalization techniques implemented in the semantic web. The medical guidelines for UTI treatment were formalized into BBN and FCM knowledge models. To assess the formal models’ performance, 55 patient cases were extracted from a database and analyzed. The results showed that the suggested approaches formalized medical knowledge efficiently in the semantic web, and gave a front-end decision on antibiotics’ suggestion for UTI.     

Soft computing for crisis management and political decision making: the use of genetically evolved fuzzy cognitive maps

This paper examines the use of fuzzy cognitive maps (FCMs) as a technique for modeling political and strategic issues situations and supporting the decision-making process in view of an imminent crisis. Its object domain is soft computing using as its basic elements different methods from the areas of fuzzy logic, cognitive maps, neural networks and genetic algorithms. FCMs, more specifically, use notions borrowed from artificial intelligence and combine characteristics of both fuzzy logic and neural networks, in the form of dynamic models that describe a given political setting. The present work proposes the use of the genetically evolved certainty neuron fuzzy cognitive map (GECNFCM) as an extension of certainty neuron fuzzy cognitive maps (CNFCMs) aiming at overcoming the main weaknesses of the latter, namely the recalculation of the weights corresponding to each concept every time a new strategy is adopted. This novel technique combines CNFCMs with genetic algorithms (GAs), the advantage of which lies with their ability to offer the optimal solution without a problem-solving strategy, once the requirements are defined. Using a multiple scenario analysis we demonstrate the value of such a hybrid technique in the context of a model that reflects the political and strategic complexity of the Cyprus issue, as well as the uncertainties involved in it. The issue has been treated on a purely technical level, with distances carefully kept concerning all sides involved in it.     

Interrogating the structure of fuzzy cognitive maps

 Causal algebra in fuzzy cognitive maps (FCMs) plays a critical role in the analysis and design of FCMs. Improving causal algebra in FCMs to model complicated situations has been one of the major research topics in this area. In this paper we propose a dynamic causal algebra in FCMs which can improve FCMs' inference and representation capability. The dynamic causal algebra shows that the indirect, strongest, weakest and total effects a vertex influences another in the FCM not only depend on the weights along all directed paths between the two vertices but also the states of the vertices on the directed paths. Therefore, these effects are nonlinear dynamic processes determined by initial conditions and propagated in the FCM to reach a static or cyclic pattern. We test our theory with a simple example.     

Linear and sigmoidal fuzzy cognitive maps: An analysis of fixed points

Fuzzy cognitive mapping is commonly used as a participatory modelling technique whereby stakeholders create a semi-quantitative model of a system of interest. This model is often turned into an iterative map, which should (ideally) have a unique stable fixed point. Several methods of doing this have been used in the literature but little attention has been paid to differences in output such different approaches produce, or whether there is indeed a unique stable fixed point. In this paper, we seek to highlight and address some of these issues. In particular we state conditions under which the ordering of the variables at stable fixed points of the linear fuzzy cognitive map (iterated to) is unique. Also, we state a condition (and an explicit bound on a parameter) under which a sigmoidal fuzzy cognitive map is guaranteed to have a unique fixed point, which is stable. These generic results suggest ways to refine the methodology of fuzzy cognitive mapping. We highlight how they were used in an ongoing case study of the shift towards a bio-based economy in the Humber region of the UK.     

Multitemporal SAR images for monitoring cultivation systems using case-based reasoning

This paper demonstrates that multitemporal satellite SAR images are most suitable for monitoring the rapid changes of cultivation systems in a subtropical region. A new method is proposed by applying case-based reasoning (CBR) techniques to the classification of SAR images. Stratified sampling is carried out to collect the cases so that the variations of backscatters within a class can be appropriately captured. The use of discrete cases can conveniently represent the internal changes of a class under complicated situations, such as spatial changes in soil conditions and terrain features. These spatial variations are difficult to represent by using rules or mathematical equations. The proposed method has better classification performance than supervised classification methods in the study area. The case library is reusable for time-independent classification when the SAR images are acquired at the same time of the crop growth cycles for different years. The proposed method has been tested in the Pearl River Delta in South China.     

Fuzzy methods for case-based recommendation and decision support

The paper proposes two case-based methods for recommending decisions to users on the basis of information stored in a database. In both approaches, fuzzy sets and related (approximate) reasoning techniques are used for modeling user preferences and decision principles in a flexible manner. The first approach, case-based decision making, can principally be seen as a case-based counterpart to classical decision principles well-known from statistical decision theory. The second approach, called case-based elicitation, combines aspects from flexible querying of databases and case-based prediction. Roughly, imagine a user who aims at choosing an optimal alternative among a given set of options. The preferences with respect to these alternatives are formalized in terms of flexible constraints, the expression of which refers to cases stored in a database. As both types of decision support might provide useful tools for recommender systems, we also place the methods in a broader context and discuss the role of fuzzy set theory in some related fields.     

CaBMA: a case-based reasoning system for capturing,refining, and reusing project plans

In this paper, we present CaBMA, a prototype of a knowledge-based system designed to assist with project planning tasks using case-based reasoning. CaBMA introduces a novel approach to project planning in that, for the first time, a knowledge layer is added on top of traditional project management software. Project management software provides editing and bookkeeping capabilities. CaBMA enhances these capabilities by automatically capturing project plans in the form of cases, refining these cases over time to avoid potential inconsistency between them, reusing these cases to generate plans for new projects, and indicating possible repairs for project plans when they derive away from existing knowledge. We will give an overview of the system, provide a detailed explanation on each component, and present an empirical study based on synthetic data.     

Fuzzy cognitive map software tool for treatment management of uncomplicated urinary tract infection

Uncomplicated urinary tract infection (uUTI) is a bacterial infection that affects individuals with normal urinary tracts from both structural and functional perspective. The appropriate antibiotics and treatment suggestions to individuals suffer of uUTI is an important and complex task that demands a special attention. How to decrease the unsafely use of antibiotics and their consumption is an important issue in medical treatment. Aiming to model medical decision making for uUTI treatment, an innovative and flexible approach called fuzzy cognitive maps (FCMs) is proposed to handle with uncertainty and missing information. The FCM is a promising technique for modeling knowledge and/or medical guidelines/treatment suggestions and reasoning with it. A software tool, namely FCM-uUTI DSS, is investigated in this work to produce a decision support module for uUTI treatment management. The software tool was tested (evaluated) in a number of 38 patient cases, showing its functionality and demonstrating that the use of the FCMs as dynamic models is reliable and good. The results have shown that the suggested FCM-uUTI tool gives a front-end decision on antibiotics’ suggestion for uUTI treatment and are considered as helpful references for physicians and patients. Due to its easy graphical representation and simulation process the proposed FCM formalization could be used to make the medical knowledge widely available through computer consultation systems.     

Improving fuzzy cognitive maps learning through memetic particle swarm optimization

Fuzzy cognitive maps constitute a neuro-fuzzy modeling methodology that can simulate complex systems accurately. Although their configuration is defined by experts, learning schemes based on evolutionary and swarm intelligence algorithms have been employed for improving their efficiency and effectiveness. This paper comprises an extensive study of the recently proposed swarm intelligence memetic algorithm that combines particle swarm optimization with both deterministic and stochastic local search schemes, for fuzzy cognitive maps learning tasks. Also, a new technique for the adaptation of the memetic schemes, with respect to the available number of function evaluations per application of the local search, is proposed. The memetic learning schemes are applied on four real-life problems and compared with established learning methods based on the standard particle swarm optimization, differential evolution, and genetic algorithms, justifying their superiority.     

Achieving quality assurance functionality in the food industry using a hybrid case-based reasoning and fuzzy logic approach

Quality control of food inventories in the warehouse is complex as well as challenging due to the fact that food can easily deteriorate. Currently, this difficult storage problem is managed mostly by using a human dependent quality assurance and decision making process. This has however, occasionally led to unimaginative, arduous and inconsistent decisions due to the injection of subjective human intervention into the process. Therefore, it could be said that current practice is not powerful enough to support high-quality inventory management. In this paper, the development of an integrative prototype decision support system, namely, Intelligent Food Quality Assurance System (IFQAS) is described which will assist the process by automating the human based decision making process in the quality control of food storage. The system, which is composed of a Case-based Reasoning (CBR) engine and a Fuzzy rule-based Reasoning (FBR) engine, starts with the receipt of incoming food inventory. With the CBR engine, certain quality assurance operations can be suggested based on the attributes of the food received. Further of this, the FBR engine can make suggestions on the optimal storage conditions of inventory by systematically evaluating the food conditions when the food is receiving. With the assistance of the system, a holistic monitoring in quality control of the receiving operations and the storage conditions of the food in the warehouse can be performed. It provides consistent and systematic Quality Assurance Guidelines for quality control which leads to improvement in the level of customer satisfaction and minimization of the defective rate.     

Integrating gray system theory and logistic regression into case-based reasoning for safety assessment of thermal power plants

Safety assessment of thermal power plants (TPPs) is one of the important means to guarantee the safety of production in thermal power production enterprises. Due to various technical limitations, existing assessment approaches, such as analytic hierarchy process (AHP), Monte Carlo methods, artificial neural network (ANN), etc., are unable to meet the requirements of the complex security assessment of TPPs. Currently, most of the security assessments of TPP are completed by the means of experts’ evaluations. Accordingly, the assessment conclusions are greatly affected by the subjectivity of the experts. Essentially, the evaluation of power plant systems relies to a large extent on the knowledge and length of experience of the experts. Therefore in this domain case-based reasoning (CBR) is introduced for the security assessment of TPPs since this methodology models expertise through experience management. Taking the management system of TPPs as breakthrough point, this paper presents a case-based approach for the Safety assessment decision support of TPPs (SATPP). First, this paper reviews commonly used approaches for TPPs security assessment and the current general evaluation process of TPPs security assessment. Then a framework for the Management System Safety Assessment of Thermal Power Plants (MSSATPP) is constructed and an intelligent decision support system for MSSATPP (IDSS-MSSATPP) is functionally designed. IDSS-MSSATPP involves several key technologies and methods such as knowledge representation and case matching. A novel case matching method named Improved Gray CBR (IGCBR) has been developed in which a statistical approach (logistic regression) and Gray System theory are integrated. Instead of applying Gray System theory directly, it has been improved to integrate it better into CBR. In addition this paper describes an experimental prototype system of IDSS-MSSATPP (CBRsys-TPP) in which IGCBR is integrated. The experimental results based on a MSSATPP data set show that CBRsys-TPP has high accuracy and systematically good performance. Further comparative studies with several other common classification approaches also show its competitive power in terms of accuracy and the synergistic effects of the integrated components.     

Fuzzy arithmetic-based interpolative reasoning for nonlinear dynamic fuzzy systems

FAIR (fuzzy arithmetic-based interpolative reasoning)—a fuzzy reasoning scheme based on fuzzy arithmetic, is presented here. Linguistic rules of the Mamdani type, with fuzzy numbers as consequents, are used in an inference mechanism similar to that of a Takagi–Sugeno model. The inference result is a weighted sum of fuzzy numbers, calculated by means of the extension principle. Both fuzzy and crisp inputs and outputs can be used, and the chaining of rule bases is supported without increasing the spread of the output fuzzy sets in each step. This provides a setting for modeling dynamic fuzzy systems using fuzzy recursion. The matching in the rule antecedents is done by means of a compatibility measure that can be selected to suit the application at hand. Different compatibility measures can be used for different antecedent variables, and reasoning with sparse rule bases is supported. The application of FAIR to the modeling of a nonlinear dynamic system based on a combination of knowledge-driven and data-driven approaches is presented as an example.     

A framework for the analysis of dynamic processes based on Bayesian networks and case-based reasoning

Bayesian networks are knowledge representation schemes that can capture probabilistic relationships among variables and perform probabilistic inference. Arrival of new evidence propagates through the network until all variables are updated. At the end of propagation, the network becomes a static snapshot representing the state of the domain for that particular time. This weakness in capturing temporal semantics has limited the use of Bayesian networks to domains in which time dependency is not a critical factor. This paper describes a framework that combines Bayesian networks and case-based reasoning to create a knowledge representation scheme capable of dealing with time-varying processes. Static Bayesian network topologies are learned from previously available raw data and from sets of constraints describing significant events. These constraints are defined as sets of variables assuming significant values. As new data are gathered, dynamic changes to the topology of a Bayesian network are assimilated using techniques that combine single-value decomposition and minimum distance length. The new topologies are capable of forecasting the occurrences of significant events given specific conditions and monitoring changes over time. Since environment problems are good examples of temporal variations, the problem of forecasting ozone levels in Mexico City was used to test this framework.