Three-stage intelligent support of clinical decision making for higher trust, validity, and explainability
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The paper presents the approach for the building of consistent and applicable clinical decision support systems (CDSS) using a data-driven predictive model aimed to resolve a problem of low applicability and scalability of CDSS in real-world applications. The approach is based on the three-stage application of domain-specific and data-driven supportive procedures to integrate into clinical business-processes with higher trust and explainability of the prediction results and recommendations. Within the considered three stages, the regulatory policy, data-driven modes, and interpretation procedures are integrated to enable natural domain-specific interaction with decision-makers with sequential narrowing of the intelligent decision support focus. The proposed methodology enables a higher level of automation, scalability, and semantic interpretability of CDSS. The approach was implemented in software solutions and tested within a case study in T2DM prediction, enabling to improve known clinical scales (such as FINDRISK), keeping the problem-specific reasoning interface similar to existing applications. Such inheritance, together with the three-stages approach, provide higher compatibility of the solution and leads to trust, valid, and explainable application of data-driven solution in real-world cases.
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