Skip to main content

Toward Probabilistic Analysis of Guidelines

  • Conference paper
Book cover Knowledge Representation for Health-Care (KR4HC 2010)

Part of the book series: Lecture Notes in Computer Science ((LNAI,volume 6512))

Included in the following conference series:

  • 464 Accesses

Abstract

In the formal analysis of health-care, there is little work that combines probabilistic and temporal reasoning. On the one hand, there are those that aim to support the clinical thinking process, which is characterised by trade-off decision making taking into account uncertainty and preferences, i.e., the process has a probabilistic and decision-theoretic flavour. On the other hand, the management of care, e.g., guidelines and planning of tasks, is typically modelled symbolically using temporal, non-probabilistic, methods. This paper proposes a new framework for combining temporal reasoning with probabilistic decision making. The framework is instantiated with a guideline modelling language combined with probabilistic pharmokinetics and applied to the treatment of diabetes mellitus type 2.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 39.99
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 54.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. Andreassen, S., Jensen, F.V., Andersen, S.K., Falck, B., Kjærulff, U., Woldbye, M., Sørensen, A.R., Rosenfalck, A., Jensen, F.: MUNIN – an expert EMG assistant. In: Desmedt, J.E. (ed.) Computer-Aided Electromyography and Expert Systems, pp. 255–277. Elsevier, Amsterdam (1989)

    Google Scholar 

  2. Balser, M., Duelli, C., Reif, W.: Formal semantics of Asbru - an overview. In: Proceedings of the International Conference on Integrated Design and Process Technology, Passadena. Society for Design and Process Science (June 2002)

    Google Scholar 

  3. Beck, J.R., Pauler, S.G.: The Markov process in medical prognosis. Medical Decision Making 3, 419–458 (1983)

    Article  Google Scholar 

  4. de Clercq, P., Kaiser, K., Hasman, A.: Computer-interpretable guideline formalisms. In: ten Teije, A., Miksch, S., Lucas, P.J.F. (eds.) Computer-based Medical Guidelines and Protocols: A Primer and Current Trends, pp. 22–43. IOS Press, Amsterdam (2008)

    Google Scholar 

  5. Fox, J., Das, S.: Safe and Sound: Artificial Intelligence in Hazardous Applications. MIT Press, Cambridge (2000)

    Google Scholar 

  6. Garber, A.J., Duncan, T.G., Goodman, A.M., Mills, D.J., Rohlf, J.L.: Efficacy of metformin in type ii diabetes: results of a double-blind, placebo-controlled, dose-response trial. Am. J. Med. 103(6), 491–507 (1997)

    Article  Google Scholar 

  7. Getoor, L., Taskar, B. (eds.): Introduction to Statistical Relational Learning. Adaptive Computation and Machine Learning. MIT Press, Cambridge (2007)

    MATH  Google Scholar 

  8. Hermann, L.S., Scherstén, B., Bitzén, P.O., Kjellström, T., Lindgärde, F., Melander, A.: Therapeutic comparison of metformin and sulfonylurea, alone and in various combinations. Diabetes Care 16(10), 1100–1109 (1994)

    Article  Google Scholar 

  9. Hommersom, A.J.: On the Application of Formal Methods to Clinical Guidelines. PhD thesis, University of Nijmegen (2008)

    Google Scholar 

  10. Hommersom, A.J., Groot, P.C., Balser, M., Lucas, P.J.F.: Formal methods for verification of clinical practice guidelines. In: ten Teije, A., Miksch, S., Lucas, P.J.F. (eds.) Computer-based Medical Guidelines and Protocols: A Primer and Current Trends, pp. 63–80. IOS Press, Amsterdam (2008)

    Google Scholar 

  11. Hong, Y., Rohatagi, S., Habtemariam, B., Walker, J.R., Schwartz, S.L., Mager, D.E.: Population exposure-response modeling of metformin inpatients with type 2 diabetes mellitus. J. Clin. Pharmacol. 48(6), 696–707 (2008)

    Article  Google Scholar 

  12. Hollenberg, J.P.: Markov cycle trees: a new representation for complex Markov processes (abstr). Medical Decision Making 4, 529 (1984)

    MathSciNet  Google Scholar 

  13. Kwiatkowska, M., Norman, G., Parker, D.: PRISM: Probabilistic symbolic model checker. In: Field, T., Harrison, P.G., Bradley, J., Harder, U. (eds.) TOOLS 2002. LNCS, vol. 2324, pp. 200–204. Springer, Heidelberg (2002)

    Google Scholar 

  14. Lucas, P.J.F., De Bruijn, N., Schurink, K., Hoepelman, A.: A probabilistic and decision-theoretic approach to the management of infectious disease at the icu. Artificial Intelligence in Medicine 19, 251–279 (2000)

    Article  Google Scholar 

  15. NHS. The guidelines manual, http://www.nice.org.uk/media/68D/3C/The_guidelines_manual_2009_-_Chapter_9_Developing_and_wording_guideline_recommendations.pdf

  16. Peleg, M., Tu, S., Bury, J., Ciccarese, P., Fox, J.: Comparing computer-interpretable guideline models: a case-study approach. Journal of the American Medical Informatics Association 10(1), 52–68 (2003)

    Article  Google Scholar 

  17. Reitman, M.L., Schadt, E.E.: Pharmacogenetics of metformin response: a step in the path toward personalized medicine. J. Clin. Invest. 117(5) (2007)

    Google Scholar 

  18. Scarpello, J.H.B., Howlett, H.C.S.: Metformin therapy and clinical uses. Diab. Vasc. Dis. Res. 5(3), 157–167 (2008)

    Article  Google Scholar 

  19. Shahar, Y., Miksch, S., Johnson, P.: The Asgaard Project: a task-specific framework for the application and critiquing of time-oriented clinical guidelines. Artificial Intelligence in Medicine 14, 29–51 (1998)

    Article  Google Scholar 

  20. Shu, Y., Sheardown, S.A., Brown, C., Owen, R.P., Zhang, S., Castro, R.A., Ianculescu, A.G., Yue, L., Lo, J.C., Burchard, E.G., Brett, C.M., Giacomini, K.M.: Effect of genetic variation in the organic cation transporter 1 (OCT1) on metformin action. J. Clin. Invest. 117, 1422–1431 (2007)

    Article  Google Scholar 

  21. Sonnenberg, F.A., Beck, J.R.: Markov models in medical decision making: A practical guide. Medical Decision Making 13(4), 322–338 (1993)

    Article  Google Scholar 

  22. Terenziani, P., Molino, G., Torchio, M.: A modular approach for representing and executing clinical gui delines. Artificial Intelligence in Medicine 23, 249–276 (2001)

    Article  Google Scholar 

  23. Timbie, J.W., Hayward, R.A., Vijan, S.: Variation in the net benefit of aggressive cardiovascular risk factor control across the us population of patients with diabetes mellitus. Archives of Internal Medicine 170(12), 1037–1044 (2010)

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2011 Springer-Verlag Berlin Heidelberg

About this paper

Cite this paper

Hommersom, A. (2011). Toward Probabilistic Analysis of Guidelines. In: Riaño, D., ten Teije, A., Miksch, S., Peleg, M. (eds) Knowledge Representation for Health-Care. KR4HC 2010. Lecture Notes in Computer Science(), vol 6512. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-18050-7_11

Download citation

  • DOI: https://doi.org/10.1007/978-3-642-18050-7_11

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-642-18049-1

  • Online ISBN: 978-3-642-18050-7

  • eBook Packages: Computer ScienceComputer Science (R0)

Publish with us

Policies and ethics