Temporal reasoning for diagnosis in a causal probabilistic knowledge base.

We have added temporal reasoning to the Heart Disease Program (HDP) to take advantage of the temporal constraints inherent in cardiovascular reasoning. Some processes take place over minutes while others take place over months or years and a strictly probabilistic formalism can generate hypotheses that are impossible given the temporal relationships involved. The HDP has temporal constraints on the causal relations specified in the knowledge base and temporal properties on the patient input provided by the user. These are used in two ways. First, they are used to constrain the generation of the pre-computed causal pathways through the model that speed the generation of hypotheses. Second, they are used to generate time intervals for the instantiated nodes in the hypotheses, which are matched and adjusted as nodes are added to each evolving hypothesis. This domain offers a number of challenges for temporal reasoning. Since the nature of diagnostic reasoning is inferring a causal explanation from the evidence, many of the temporal intervals have few constraints and the reasoning has to make maximum use of those that exist. Thus, the HDP uses a temporal interval representation that includes the earliest and latest beginning and ending specified by the constraints. Some of the disease states can be corrected but some of the manifestations may remain. For example, a valve disease such as aortic stenosis produces hypertrophy that remains long after the valve has been replaced. This requires multiple time intervals to account for the existing findings. This paper discusses the issues and solutions that have been developed for temporal reasoning integrated with a pseudo-Bayesian probabilistic network in this challenging domain for diagnosis.