A belief rule-based decision support system for clinical risk assessment of cardiac chest pain

This paper describes a prototype clinical decision support system (CDSS) for risk stratification of patients with cardiac chest pain. A newly developed belief rule-based inference methodology-RIMER was employed for developing the prototype. Based on the belief rule-based inference methodology, the prototype CDSS can deal with uncertainties in both clinical domain knowledge and clinical data. Moreover, the prototype can automatically update its knowledge base via a belief rule base (BRB) learning module which can adjust BRB through accumulated historical clinical cases. The domain specific knowledge used to construct the knowledge base of the prototype was learned from real patient data. We simulated a set of 1000 patients in cardiac chest pain to validate the prototype. The belief rule-based prototype CDSS has been found to perform extremely well. Firstly, the system can provide more reliable and informative diagnosis recommendations than manual diagnosis using traditional rules when there are clinical uncertainties. Secondly, the diagnostic performance of the system can be significantly improved after training the BRB through accumulated clinical cases. © 2011 Elsevier B.V. All rights reserved.