Sistema de Apoio à Decisão Aplicado ao Diagnóstico da Doença de Alzheimer
Resumo
Este artigo descreve um sistema de suporte à decisão clínica, aplicado ao diagnóstico da Doença de Alzheimer. Os principais componentes presentes no sistema são: um modelo de conhecimento baseado em rede bayesiana, uma ontologia para representação do conhecimento clínico e incertezas, um motor de inferência e aprendizagem computacional. A estrutura da rede bayesiana foi baseada nos critérios clínicos publicados pelo NINCDS-ADRDA e DSM-IV. Os parâmetros da rede foram definidos aplicando o algoritmo de aprendizagem computacional conhecido como Expectation Maximization (EM). A base de treinamento foi baseada em dados clínicos de cerca de 1500 indivíduos obtidos do CERAD. Os resultados foram avaliados através de uma análise de sensibilidade.Referências
APA (1994). Diagnostic and Statistical Manual of Mental Disorders DSM-IV. Washington, DC, American Psychiatric Association.
Bottino, C. M. C., D. Azevedo, M. Tatsch, S. R. Hototian, M. A. Moscoso, J. Folquitto, A. Z. Scalco, M. C. Bazzarella, M. A. Lopes and J. Litvoc (2008). "Estimate of dementia prevalence in a community sample from São Paulo." Dementia and Geriatric Cognitive Disorders 26(4): 291-299.
Dempster, A. P., N. M. Laird and D. B. Rubin (1977). "Maximum likelihood from incomplete data via the EM algorithm." Journal of the Royal Statistical Society. Series B (Methodological) 39(1): 1-38.
do Amaral, M. B., Y. Satomura, M. Honda and T. Sato (1995). "A psychiatric diagnostic system integrating probabilistic and categorical reasoning." Methods Inf Med 34(3): 232-243.
Dubois, B., H. H. Feldman, C. Jacova, S. T. DeKosky, P. Barberger-Gateau, J. Cummings, A. Delacourte, D. Galasko, S. Gauthier, K. Meguro, J. O'Brien, F. Pasquier, P. Robert, M. Rossor, S. Salloway, Y. Stern, P. J. Visser and P. Scheltens (2007). "Research criteria for the diagnosis of Alzheimer's Disease: revising the NINCDS-ADRDA criteria." Lancet Neurology 6: 734-746.
Fayyad, U. M. and K. B. Irani (1993). Multi-interval discretisation of continuous-valued attributes for classification. Proceedings of the Thirteenth Internatinal Joint Conference on Artificial Intelligence, San Fracisco CA, Morgan Kaufmann.
Fillenbaum, G. G., G. van Belle, J. C. Morris, R. C. Mohs, S. S. Mirra, P. C. Davis, P. N. Tariot, J. M. Silverman, C. M. Clark and K. A. Welsh-Bohmer (2008). "Consortium to Establish a Registry for Alzheimer’s Disease (CERAD): The first twenty years." Alzheimer's & dementia: the journal of the Alzheimer's Association 4(2): 96-109.
Friedman, N. (1997). Learning belief networks in the presence of missing values and hidden variables. Proceedings of the Fourteenth International Conference on Machine Learning, San Francisco CA, Morgan Kaufmann.
Gopalan, R. and D. A. Berry (1998). "Bayesian multiple comparisons using Dirichlet process priors." Journal of the American Statistical Association 93(443): 1130-1139.
Korb, K. and A. Nicholson (2004). Bayesian artificial intelligence. Clayton, Victoria, Australia, Chapman & Hall/CRC.
Lindgren, H. (2007). Decision support in dementia care: developing systems for interactive reasoning, Umeå University, Faculty of Science and Technology, Computing Science.
Maia, A. L. G., C. Godinho, E. D. Ferreira, V. Almeida, A. Schuh, J. Kaye and M. L. F. Chaves (2006). "Application of the Brazilian version of the CDR scale in samples of dementia patients." Arquivos de Neuro-Psiquiatria 64(2B): 485-489.
McKhann, G., D. Drachman, M. Folstein, R. Katzman, D. Price and E. M. Stadlan (1984). "Clinical diagnosis of Alzheimer's disease: Report of the NINCDS-ADRDA Work Group under the auspices of Department of Health and Human Services Task Force on Alzheimer's Disease." Neurology 34(7): 939-944.
Mirra, S. S., A. Heyman, D. McKeel, S. M. Sumi, B. J. Crain, L. M. Brownlee, F. S. Vogel, J. P. Hughes, G. van Belle and L. Berg (1991). "The Consortium to Establish a Registry for Alzheimer's Disease (CERAD). Part II. Standardization of the neuropathologic assessment of Alzheimer's disease." Neurology 41(4): 479-486.
Mueller, S. G., N. Schuff, K. Yaffe, C. Madison, B. Miller and M. W. Weiner (2010). "Hippocampal atrophy patterns in mild cognitive impairment and Alzheimer's disease." Hum Brain Mapp 31(9): 1339-1347.
Murphy, K. (2001). "The bayes net toolbox for matlab." Computing science and statistics 33(2): 1024-1034.
Shwe, M. A., B. Middleton, D. Heckerman, M. Henrion, E. Horvitz, H. Lehmann and G. Cooper (1991). "Probabilistic diagnosis using a reformulation of the INTERNIST-1/QMR knowledge base." Methods of information in medicine 30(4): 241-255.
Sirajuddin, A. M., J. A. Osheroff, D. F. Sittig, J. Chuo, F. Velasco and D. A. Collins (2009). "Implementation pearls from a new guidebook on improving medication use and outcomes with clinical decision support. Effective CDS is essential for addressing healthcare performance improvement imperatives." J Healthc Inf Manag 23(4): 38-45.
Bottino, C. M. C., D. Azevedo, M. Tatsch, S. R. Hototian, M. A. Moscoso, J. Folquitto, A. Z. Scalco, M. C. Bazzarella, M. A. Lopes and J. Litvoc (2008). "Estimate of dementia prevalence in a community sample from São Paulo." Dementia and Geriatric Cognitive Disorders 26(4): 291-299.
Dempster, A. P., N. M. Laird and D. B. Rubin (1977). "Maximum likelihood from incomplete data via the EM algorithm." Journal of the Royal Statistical Society. Series B (Methodological) 39(1): 1-38.
do Amaral, M. B., Y. Satomura, M. Honda and T. Sato (1995). "A psychiatric diagnostic system integrating probabilistic and categorical reasoning." Methods Inf Med 34(3): 232-243.
Dubois, B., H. H. Feldman, C. Jacova, S. T. DeKosky, P. Barberger-Gateau, J. Cummings, A. Delacourte, D. Galasko, S. Gauthier, K. Meguro, J. O'Brien, F. Pasquier, P. Robert, M. Rossor, S. Salloway, Y. Stern, P. J. Visser and P. Scheltens (2007). "Research criteria for the diagnosis of Alzheimer's Disease: revising the NINCDS-ADRDA criteria." Lancet Neurology 6: 734-746.
Fayyad, U. M. and K. B. Irani (1993). Multi-interval discretisation of continuous-valued attributes for classification. Proceedings of the Thirteenth Internatinal Joint Conference on Artificial Intelligence, San Fracisco CA, Morgan Kaufmann.
Fillenbaum, G. G., G. van Belle, J. C. Morris, R. C. Mohs, S. S. Mirra, P. C. Davis, P. N. Tariot, J. M. Silverman, C. M. Clark and K. A. Welsh-Bohmer (2008). "Consortium to Establish a Registry for Alzheimer’s Disease (CERAD): The first twenty years." Alzheimer's & dementia: the journal of the Alzheimer's Association 4(2): 96-109.
Friedman, N. (1997). Learning belief networks in the presence of missing values and hidden variables. Proceedings of the Fourteenth International Conference on Machine Learning, San Francisco CA, Morgan Kaufmann.
Gopalan, R. and D. A. Berry (1998). "Bayesian multiple comparisons using Dirichlet process priors." Journal of the American Statistical Association 93(443): 1130-1139.
Korb, K. and A. Nicholson (2004). Bayesian artificial intelligence. Clayton, Victoria, Australia, Chapman & Hall/CRC.
Lindgren, H. (2007). Decision support in dementia care: developing systems for interactive reasoning, Umeå University, Faculty of Science and Technology, Computing Science.
Maia, A. L. G., C. Godinho, E. D. Ferreira, V. Almeida, A. Schuh, J. Kaye and M. L. F. Chaves (2006). "Application of the Brazilian version of the CDR scale in samples of dementia patients." Arquivos de Neuro-Psiquiatria 64(2B): 485-489.
McKhann, G., D. Drachman, M. Folstein, R. Katzman, D. Price and E. M. Stadlan (1984). "Clinical diagnosis of Alzheimer's disease: Report of the NINCDS-ADRDA Work Group under the auspices of Department of Health and Human Services Task Force on Alzheimer's Disease." Neurology 34(7): 939-944.
Mirra, S. S., A. Heyman, D. McKeel, S. M. Sumi, B. J. Crain, L. M. Brownlee, F. S. Vogel, J. P. Hughes, G. van Belle and L. Berg (1991). "The Consortium to Establish a Registry for Alzheimer's Disease (CERAD). Part II. Standardization of the neuropathologic assessment of Alzheimer's disease." Neurology 41(4): 479-486.
Mueller, S. G., N. Schuff, K. Yaffe, C. Madison, B. Miller and M. W. Weiner (2010). "Hippocampal atrophy patterns in mild cognitive impairment and Alzheimer's disease." Hum Brain Mapp 31(9): 1339-1347.
Murphy, K. (2001). "The bayes net toolbox for matlab." Computing science and statistics 33(2): 1024-1034.
Shwe, M. A., B. Middleton, D. Heckerman, M. Henrion, E. Horvitz, H. Lehmann and G. Cooper (1991). "Probabilistic diagnosis using a reformulation of the INTERNIST-1/QMR knowledge base." Methods of information in medicine 30(4): 241-255.
Sirajuddin, A. M., J. A. Osheroff, D. F. Sittig, J. Chuo, F. Velasco and D. A. Collins (2009). "Implementation pearls from a new guidebook on improving medication use and outcomes with clinical decision support. Effective CDS is essential for addressing healthcare performance improvement imperatives." J Healthc Inf Manag 23(4): 38-45.
Publicado
19/07/2011
Como Citar
SEIXAS, Flávio L.; ZADROZNY, Bianca; LAKS, Jerson; SAADE, Débora C. M.; CONCI, Aura.
Sistema de Apoio à Decisão Aplicado ao Diagnóstico da Doença de Alzheimer. In: SIMPÓSIO BRASILEIRO DE COMPUTAÇÃO APLICADA À SAÚDE (SBCAS), 11. , 2011, Natal/RN.
Anais [...].
Porto Alegre: Sociedade Brasileira de Computação,
2011
.
p. 1862-1871.
ISSN 2763-8952.
