title: Development of a clinical decision support system using genetic algorithms and Bayesian classification for improving the personalised management of women attending a colposcopy room.
abstract: Cervical cancer (CxCa) is often the result of underestimated abnormalities in the test Papanicolaou (Pap test). The recent advances in the study of the human papillomavirus (HPV) infection (the necessary cause for CxCa development) have guided clinical practice to add HPV related tests alongside the Pap test. In this way, today, HPV DNA testing is well accepted as an ancillary test and it is used for the triage of women with abnormal findings in cytology. However, these tests are either highly sensitive or highly specific, and therefore none of them provides an optimal solution. In this Letter, a clinical decision support system based on a hybrid genetic algorithm - Bayesian classification framework is presented, which combines the results of the Pap test with those of the HPV DNA test in order to exploit the benefits of each method and produce more accurate outcomes. Compared with the medical tests and their combinations (co-testing), the proposed system produced the best receiver operating characteristic curve and the most balanced combination among sensitivity and specificity in detecting high-grade cervical intraepithelial neoplasia and CxCa (CIN2+). This system may support decision-making for the improved management of women who attend a colposcopy room following a positive test result.
authors.affiliation: Biomedical Engineering Laboratory, School of Electrical and Computer Engineering , National Technical University of Athens , Athens 15773 , Greece.
authors.forename: Panagiotis
authors.identifier: 0000-0002-9194-5987
authors.initials: P
authors.lastname: Bountris
authors.affiliation: Biomedical Engineering Laboratory, School of Electrical and Computer Engineering , National Technical University of Athens , Athens 15773 , Greece.
authors.forename: Elena
authors.initials: E
authors.lastname: Topaka
authors.affiliation: Department of Cytopathology , 'Attikon' University Hospital, National and Kapodistrian University of Athens , Athens 12462 , Greece.
authors.forename: Abraham
authors.identifier: 0000-0002-0074-3619
authors.initials: A
authors.lastname: Pouliakis
authors.affiliation: Institute of Communication and Computer Systems , Athens 10682 , Greece.
authors.forename: Maria
authors.identifier: 0000-0003-1136-8209
authors.initials: M
authors.lastname: Haritou
authors.affiliation: Department of Cytopathology , 'Attikon' University Hospital, National and Kapodistrian University of Athens , Athens 12462 , Greece.
authors.forename: Petros
authors.initials: P
authors.lastname: Karakitsos
authors.affiliation: Biomedical Engineering Laboratory, School of Electrical and Computer Engineering , National Technical University of Athens , Athens 15773 , Greece.
authors.forename: Dimitrios
authors.initials: D
authors.lastname: Koutsouris
keywords: Bayes methods; Bayesian classification; DNA; HPV DNA testing; Papanicolaou test; cancer; cervical cancer; characteristic curve; clinical decision support system; colposcopy room; decision support systems; genetic algorithms; high-grade cervical intraepithelial neoplasia; human papillomavirus infection; medical computing; microorganisms; personalised management