An Ontology-Based Interpretable Fuzzy Decision Support System for Diabetes Diagnosis

Diabetes is a serious chronic disease. The importance of clinical decision support systems (CDSSs) to diagnose diabetes has led to extensive research efforts to improve the accuracy, applicability, interpretability, and interoperability of these systems. However, this problem continues to require optimization. Fuzzy rule-based systems are suitable for the medical domain, where interpretability is a main concern. The medical domain is data-intensive, and using electronic health record data to build the FRBS knowledge base and fuzzy sets is critical. Multiple variables are frequently required to determine a correct and personalized diagnosis, which usually makes it difficult to arrive at accurate and timely decisions. In this paper, we propose and implement a new semantically interpretable FRBS framework for diabetes diagnosis. The framework uses multiple aspects of knowledge-fuzzy inference, ontology reasoning, and a fuzzy analytical hierarchy process (FAHP) to provide a more intuitive and accurate design. First, we build a two-layered hierarchical and interpretable FRBS; then, we improve this by integrating an ontology reasoning process based on SNOMED CT standard ontology. We incorporate FAHP to determine the relative medical importance of each sub-FRBS. The proposed system offers numerous unique and critical improvements regarding the implementation of an accurate, dynamic, semantically intelligent, and interpretable CDSS. The designed system considers the ontology semantic similarity of diabetes complications and symptoms concepts in the fuzzy rules' evaluation process. The framework was tested using a real data set, and the results indicate how the proposed system helps physicians and patients to accurately diagnose diabetes mellitusThis work was supported by National Research Foundation of Korea-Grant funded by the Korean Government (Ministry of Science, ICT and Future Planning)-NRF-2017R1A2B2012337)S

Reasoning by analogy in the generation of domain acceptable ontology refinements

Refinements generated for a knowledge base often involve the learning of new knowledge to be added to or replace existing parts of a knowledge base. However, the justifiability of the refinement in the context of the domain (domain acceptability) is often overlooked. The work reported in this paper describes an approach to the generation of domain acceptable refinements for incomplete and incorrect ontology individuals through reasoning by analogy using existing domain knowledge. To illustrate this approach, individuals for refinement are identified during the application of a knowledge-based system, EIRA; when EIRA fails in its task, areas of its domain ontology are identified as requiring refinement. Refinements are subsequently generated by identifying and reasoning with similar individuals from the domain ontology. To evaluate this approach EIRA has been applied to the Intensive Care Unit (ICU) domain. An evaluation (by a domain expert) of the refinements generated by EIRA has indicated that this approach successfully produces domain acceptable refinements