Shiffman R N, Greenes R A
Decision Systems Group, Harvard Medical School, Brigham and Women's Hospital, Boston, MA.
Proc Annu Symp Comput Appl Med Care. 1992:339-43.
Clinical practice guidelines must comprehensively address all logically possible situations, but this completeness may result in sizable and cumbersome rule sets. We applied rule set reduction techniques to a 576-rule set regarding recommendations for medication treatment of hypercholesterolemia. Using decision tables augmented with information regarding test costs and rule application frequencies, we sorted the rule sets prior to identifying irrelevant tests and eliminating unnecessary rules. Alternatively, we examined the semantic relationships among risk factors in hypercholesterolemia and applied a subsumption technique to reduce the rule set. Both methodologies resulted in substantial rule set compression (mean, 48-70%). Subsumption techniques proved superior for compacting a large rule set based on risk factors.
临床实践指南必须全面涵盖所有逻辑上可能出现的情况，但这种完整性可能导致规则集规模庞大且繁琐。我们将规则集缩减技术应用于一个关于高胆固醇血症药物治疗建议的包含576条规则的规则集。利用添加了测试成本和规则应用频率信息的决策表，我们在识别无关测试和消除不必要规则之前对规则集进行了排序。另外，我们研究了高胆固醇血症中风险因素之间的语义关系，并应用了一种包含技术来缩减规则集。两种方法都导致了规则集的大幅压缩（平均压缩48%-70%）。事实证明，基于风险因素压缩大型规则集时，包含技术更为优越。
