Case-based reasoning and imaging procedure selection

RATIONALE AND OBJECTIVES. Case-based reasoning, an artificial intelligence technique for learning and reasoning from experience, has shown great potential for use in decision support systems. The authors developed and tested a prototype case-based decision support system to explore the applicability of this technique to the selection of diagnostic imaging procedures. METHODS. A case-based system, ProtoISIS, was developed based on the Protos learning apprentice. ProtoISIS learned the domain of ultrasonography and body computed tomography by reviewing 200 consecutive cases of actual requests for imaging procedures. ProtoISIS was tested by using it to classify four sets of 25 cases of actual imaging procedure requests. RESULTS. ProtoISIS correctly classified 72% of the imaging- procedure requests. Its performance improved as it gained experience: in the last two test series, it correctly classified 84% of the cases presented. CONCLUSIONS. Case-based reasoning can be applied successfully to the selection of diagnostic imaging procedures and holds potential for use in clinical decision support aids. Further work is necessary to realize a clinically useful system.