Case-Based Reasoning in the Health Sciences: Foundations and Research Directions - Computational Intelligence in Healthcare: Advanced Methodologies - page 126

infection would arise, ICONS would input information about the way in which
the infection was acquired, the organ system affected, contraindications, and
general patient data needed for dosage calculation. It would retrieve a similar
actual or prototypical case from its case base, which would contain a solution
set of potential antibiotics to prescribe. The solution set would be adapted, or
refined, based on the needs of the current patient.
CBR has long been used for educational purposes [26]. Since CBR is predi-
cated on the idea that knowledge is acquired through experience, it promotes the
approach of teaching by providing meaningful experiences, or cases. Some CBR
systems built for other purposes provide auxiliary educational benefit, as users
learn from their interactions with the system or benefit from the examples stored
in the case base. The nutritionist who served as domain expert for CAMP [27],
which planned daily menus to meet individual nutrition requirements, believed
that the case base was one of CAMP's most valuable contributions. The case
base was a large repository of nutritionally sound daily menus, an educational
resource for nutrition students that had been previously unavailable.
An early CBR-inspired system to educate the public about health was the
Sickle Cell Counselor [28]. This system was built as an interactive video exhibit
to teach museum visitors about sickle cell disease and the genetic inheritance of
the sickle cell trait. Users were given simulated experiences as genetic counselors
for virtual couples at risk of having children with sickle cell disease. Users could
carry out simulated blood tests, calculate the probabilities of a baby being born
with the disease, consult with videotaped experts, and counsel the couple as to
the advisability of having children. A virtual year later, the couple told whether
or not they had (a) taken the advice, (b) found the advice helpful, and (c) borne a
child with sickle cell disease. Tests showed that system users learned more about
sickle cell disease and genetic inheritance than control subjects given written
instructional materials covering the same topics.
Since SHRINK was first proposed, many systems have been built for diagnosis,
classification, treatment planning, education, and other tasks in a wide variety
of health sciences domains. Some additional influential systems built before the
turn of the century are noted here:
- MEDIC diagnosed pulmonary disease [29]
- BOLERO supported the diagnosis of pneumonia [30]
- FLORENCE assisted with nursing diagnosis, prognosis and prescription [31]
- ALEXIA planned assessment tests to determine a patient's hypertension
etiology [32]
- T-IDDM supported insulin-dependent diabetes mellitus patient management
[33]
- CARE-PARTNER supported long-term follow-up care of stem-cell trans-
plantation patients [34]
- The Auguste project advised physicians about prescribing neuroleptic drugs
for Alzheimer's patients [35]
- ROENTGEN helped to design radiation therapy plans for oncology pa-
tients [36]