title: Integrating case-based reasoning with an electronic patient record system.
abstract: Electronic patient records (EPRs) contain a wealth of patient-related data and capture clinical problem-solving experiences and decisions. Excelicare is such a system which is also a platform for the national generic clinical system in the UK.
  
  
  OBJECTIVE
  This paper presents, ExcelicareCBR, a case-based reasoning (CBR) system which has been developed to complement Excelicare. Objective of this work is to integrate CBR to support clinical decision making by harnessing electronic patient records for clinical experience reuse.
  
  
  METHODS
  CBR is a proven problem solving methodology in which past solutions are reused to solve new problems. A key challenge that we address in this paper is how to extract and represent a case from an EPR. Using an example from the lung cancer domain we demonstrate our generic case representation approach where Excelicare fields are mapped to case features. Once the case base is populated with cases containing data from the EPRs database a standard weighted k-nearest neighbour algorithm combined with a genetic algorithm based feature weighting mechanism is used for case retrieval and reuse.
  
  
  CONCLUSIONS
  We conclude that incorporating case authoring functionality and a generic retrieval mechanism were key to successful integration of ExcelicareCBR. This paper also demonstrates how the application of CBR can enable sharing of lessons learned through the retrieval and reuse of EPRs captured as cases in a case base.
authors.affiliation: School of Computing, The Robert Gordon University, Aberdeen, Scotland, UK. martijn.vdbranden@axsys.co.uk
authors.forename: Martijn
authors.initials: M
authors.lastname: van den Branden
authors.forename: Nirmalie
authors.initials: N
authors.lastname: Wiratunga
authors.forename: Dean
authors.initials: D
authors.lastname: Burton
authors.forename: Susan
authors.initials: S
authors.lastname: Craw
mesh_terms: D000465:Algorithms; D001185:Artificial Intelligence; D003196:Computer Graphics; D057225:Data Mining; D020000:Decision Support Systems, Clinical; D003661:Decision Support Techniques; D006801:Humans; D051188:Knowledge Bases; D008175:Lung Neoplasms / Q000532:radiotherapy*; D008490:Medical Informatics / Q000379:methods*; D016347:Medical Records Systems, Computerized; D018511:Systems Integration; D014584:User-Computer Interface