ConfidentCare：一个个性化乳腺癌筛查的临床决策支持系统
ConfidentCare: A Clinical Decision Support System for Personalized Breast Cancer Screening
摘要：
乳腺癌筛查政策试图通过对表面健康的妇女进行定期筛查来实现及时诊断。需要各种临床决策来管理筛查过程;这些决策包括：为女性选择筛查测试，解释测试结果，以及决定女性是否应该接受诊断测试。这些决定目前是由临床实践指南（CPG）指导的，这是一种一刀切的方法，旨在对一个人群进行平均工作，但不能保证它在该人群中均匀工作。由于筛查的风险和益处是每个患者特征的功能，因此需要针对个人特征定制的个性化筛查政策，以确保将正确的测试推荐给正确的女性。为了解决这个问题，我们提出了ConfidentCare：一个计算机辅助的临床决策支持系统，从电子健康记录（EHR）数据中学习个性化的筛查政策。ConfidentCare通过识别相似患者的集群，并学习针对每个集群采用的最佳筛查政策来运作。一组患者是具有相似特征（例如年龄、乳腺密度、家族史等）的一组患者，筛查政策是一套指导方针，根据妇女的特征和筛查测试分数，建议她采取什么行动。ConfidentCare算法确保为每个患者集群采用的策略以高置信度满足预定义的准确性要求。我们表明，我们的算法优于目前的CPG的成本效益和误报率。
英文摘要：
Breast cancer screening policies attempt to achieve timely diagnosis by the regular screening of apparently healthy women. Various clinical decisions are needed to manage the screening process; those include: selecting the screening tests for a woman to take, interpreting the test outcomes, and deciding whether or not a woman should be referred to a diagnostic test. Such decisions are currently guided by clinical practice guidelines (CPGs), which represent a one-size-fits-all approach that are designed to work well on average for a population, without guaranteeing that it will work well uniformly over that population. Since the risks and benefits of screening are functions of each patients features, personalized screening policies that are tailored to the features of individuals are needed in order to ensure that the right tests are recommended to the right woman. In order to address this issue, we present ConfidentCare: a computer-aided clinical decision support system that learns a personalized screening policy from the electronic health record (EHR) data. ConfidentCare operates by recognizing clusters of similar patients, and learning the best screening policy to adopt for each cluster. A cluster of patients is a set of patients with similar features (e.g. age, breast density, family history, etc.), and the screening policy is a set of guidelines on what actions to recommend for a woman given her features and screening test scores. ConfidentCare algorithm ensures that the policy adopted for every cluster of patients satisfies a predefined accuracy requirement with a high level of confidence. We show that our algorithm outperforms the current CPGs in terms of cost-efficiency and false positive rates.
机构、总结、中文摘要均由AI分析而来，可能存在错误，请以论文正文为准。
