Nicklaus Krista M, Cheong Audrey, Sampathkumar Urmila, Liu Jun, Chopra Deepti, Hoffman Aubri, Merchant Fatima A, Hanson Summer E, Markey Mia K, Reece Gregory P
Department of Biomedical Engineering, The University of Texas at Austin, Austin, Tex.
Department of Plastic Surgery, The University of Texas MD Anderson Cancer Center, Houston, Tex.
Plast Reconstr Surg Glob Open. 2022 Nov 3;10(11):e4615. doi: 10.1097/GOX.0000000000004615. eCollection 2022 Nov.
Appearance counseling is an important component of the consent process for breast reconstruction. The purpose of appearance counseling is to help the patient form realistic expectations of what she might look like after breast reconstruction. In this article, we introduce a recommender system, "BreastDecisions," for appearance counseling that suggests photographs of previous patients that are tailored to a specific patient to help her form realistic expectations of her own reconstruction.
We present user specifications and algorithm parameters needed to incorporate the recommender system into the appearance counseling workflow. We demonstrate the system for a common counseling scenario using a knowledgebase of previous breast reconstruction patients. The medical appropriateness of the recommended photographs for use in appearance counseling was evaluated by experts using a four-point rating system.
The recommender system presents photographs that are medically appropriate for counseling a specific patient, depicts typical outcomes, and adapts to a variety of clinical workflows. For each of 33 patients taken as examples of breast reconstruction patients, we used the system to identify photographs for appearance counseling. The baseline average medical appropriateness of the recommended photographs was between mostly appropriate (some explanation needed) and medically appropriate (minimal explanation needed). We demonstrate filtering and ranking steps to reduce the number of recommended photographs and increase the average medical appropriateness.
Our recommender system automatically suggests photographs of previous breast reconstruction patients for use in counseling a patient about appearance outcomes. The system is patient-specific and customizable to a particular surgeon's practice.
外观咨询是乳房重建同意过程的重要组成部分。外观咨询的目的是帮助患者对乳房重建后的样子形成现实的期望。在本文中，我们介绍了一种用于外观咨询的推荐系统“乳房决策”，该系统会推荐为特定患者量身定制的既往患者照片，以帮助她对自己的重建效果形成现实的期望。
我们展示了将推荐系统纳入外观咨询工作流程所需的用户规范和算法参数。我们使用既往乳房重建患者的知识库，针对一个常见的咨询场景演示了该系统。专家使用四点评级系统评估了推荐用于外观咨询的照片的医学适用性。
该推荐系统展示的照片在医学上适合为特定患者提供咨询，描绘了典型的结果，并能适应各种临床工作流程。对于作为乳房重建患者示例的33名患者中的每一位，我们使用该系统为外观咨询识别照片。推荐照片的基线平均医学适用性介于大多合适（需要一些解释）和医学上合适（需要最少解释）之间。我们展示了过滤和排序步骤，以减少推荐照片的数量并提高平均医学适用性。
我们的推荐系统会自动推荐既往乳房重建患者的照片，用于就外观结果向患者提供咨询。该系统是针对患者的，并且可以根据特定外科医生的实践进行定制。
