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Elicitation and Representation of Expert Knowledge for Computer Aided Diagnosis in Mammography

Journal: Methods of Information in Medicine
Subtitle: A journal stressing, for more than 50 years, the methodology and scientific fundamentals of organizing, representing and analyzing data, information and knowledge in biomedicine and health care
ISSN: 0026-1270
Issue: 2004 (Vol. 43): Issue 3 2004
Pages: 239-246

Elicitation and Representation of Expert Knowledge for Computer Aided Diagnosis in Mammography

E. Alberdi, P. Taylor, R. Lee

CHIME, University College London, UK

Keywords

Knowledge Representation, Image processing, Computer aided diagnosis, radiology, knowledge elicitation

Summary

Objectives: To study how professional radiologists describe, interpret and make decisions about microcalcifications in mammograms. The purpose was to develop a model of the radiologists’ decision making for use in CADMIUM II, a computerized aid for mammogram interpretation that combines symbolic reasoning with image processing. Methods: In Study 1, eleven radiologists were asked to ‘think out loud’ as they interpreted 20 sets of calcifications. Participants used 159 terms to describe calcifications. We used these data to design a scheme with 50 descriptors. In Study 2, ten radiologists used the scheme to describe 40 sets of calcifications. We assessed the capacity of the terms to discriminate between benign and malignant calcifications, testing them against radiologists’ assessments of malignancy and follow-up data. Results: The descriptors that were found to be the most discriminating in Study 2 were included in CADIMUM II’s knowledge base. They were represented as arguments for either a benign or a malignant diagnosis. These arguments are the central component of the decision support provided by the system. Other components are: image processing algorithms for the detection and measurement of calcifications and a set of rules that use the measures to decide which of the arguments apply to a given set of calcifications. Conclusions: Preliminary evaluations of the CADMIUM II prototype reinforce the value of representing explicitly decision making processes in computer aided mammography and of deriving these processes from image processing measurements. Decision support is presented here at a level of description that is both relevant and meaningful to the user.

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