Case-Based Reasoning for Antibiotics Therapy Advice.pdfVIP

Case-Based Reasoning for Antibiotics Therapy Advice Rainer Schmidt a), Bernhard Pollwein b), Lothar Gierl a) a) Institut für Medizinische Informatik und Biometrie, Universit?t Rostock Rembrandtstr. 16 / 17, D-18055 Rostock, Germany Email: {rainer.schmidt , lothar.gierl} @medizin.uni-rostock.de b) Institut für An?sthesiologie, Ludwig-Maximilians Universit?t München Marchioninistr. 15, D-81377 München, Germany Abstract In this paper, we describe case-based techniques in a medical application. We have developed a prototype of an antibiotics therapy adviser within the ICONS project, where the main advantage of applying CBR techniques is to speed-up the process of computing advisable therapies. However, some adaptations do not really belong to the Case-Based Reasoning paradigm though information from former cases is considered. They deal with rather typical medical tasks, namely modifications due to information updates. In our incrementally working system we have attempted to solve the problem of the continuously increasing number of stored cases by generalising from specific single cases to more general prototypes and by subsequently erasing redundant cases. Here we present results of experiments with threshold settings for our prototype architecture. The results show that the chosen design, which has mainly been founded on experiences with diagnostic applications, is not only advantageous for this therapeutic task, but that it contains a slight drawback as well. 1. Introduction Severe bacterial infections are still a life threatening complication in intensive care medicine correlated with a high mortality [1]. Identification of bacterial pathogens is often difficult. It normally requires at least 24 hours to identify the pathogen that is responsible for an infection and at least another 24 hours to find out which antibiotics have therapeutic effects against the identified pathogen. To not endanger the patient, physicians often have to start an antimicrobial therapy be