Hao Shao-Rui, Geng Shi-Chao, Fan Lin-Xiao, Chen Jia-Jia, Zhang Qin, Li Lan-Juan
State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, the First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou 310003, China.
School of Communication, Shandong Normal University, Jinan 250014, China.
J Zhejiang Univ Sci B. 2017 May;18(5):393-401. doi: 10.1631/jzus.B1600273.
Jaundice is a common and complex clinical symptom potentially occurring in hepatology, general surgery, pediatrics, infectious diseases, gynecology, and obstetrics, and it is fairly difficult to distinguish the cause of jaundice in clinical practice, especially for general practitioners in less developed regions. With collaboration between physicians and artificial intelligence engineers, a comprehensive knowledge base relevant to jaundice was created based on demographic information, symptoms, physical signs, laboratory tests, imaging diagnosis, medical histories, and risk factors. Then a diagnostic modeling and reasoning system using the dynamic uncertain causality graph was proposed. A modularized modeling scheme was presented to reduce the complexity of model construction, providing multiple perspectives and arbitrary granularity for disease causality representations. A "chaining" inference algorithm and weighted logic operation mechanism were employed to guarantee the exactness and efficiency of diagnostic reasoning under situations of incomplete and uncertain information. Moreover, the causal interactions among diseases and symptoms intuitively demonstrated the reasoning process in a graphical manner. Verification was performed using 203 randomly pooled clinical cases, and the accuracy was 99.01% and 84.73%, respectively, with or without laboratory tests in the model. The solutions were more explicable and convincing than common methods such as Bayesian Networks, further increasing the objectivity of clinical decision-making. The promising results indicated that our model could be potentially used in intelligent diagnosis and help decrease public health expenditure.
黄疸是一种常见且复杂的临床症状,可能出现在肝病学、普通外科、儿科学、传染病学、妇科和产科领域。在临床实践中,尤其是对于欠发达地区的全科医生而言,很难辨别黄疸的病因。通过医生与人工智能工程师的合作,基于人口统计学信息、症状、体征、实验室检查、影像诊断、病史和风险因素,创建了一个与黄疸相关的综合知识库。然后提出了一种使用动态不确定因果图的诊断建模与推理系统。提出了一种模块化建模方案以降低模型构建的复杂性,为疾病因果关系表示提供多个视角和任意粒度。采用“链式”推理算法和加权逻辑运算机制,以确保在信息不完整和不确定的情况下诊断推理的准确性和效率。此外,疾病与症状之间的因果相互作用以图形方式直观地展示了推理过程。使用203个随机收集的临床病例进行验证,在模型中有或没有实验室检查时,准确率分别为99.01%和84.73%。这些解决方案比贝叶斯网络等常用方法更具可解释性和说服力,进一步提高了临床决策的客观性。这些有前景的结果表明,我们的模型可能用于智能诊断,并有助于减少公共卫生支出。