Beyond rule based reasoning - the meaning and use of cases

Commercial legal expert systems are invariably rule based. Such systems are poor at dealing with open texture and the argumentation inherent in law. To overcome these problems we suggest supplementing rule based legal expert systems with case based reasoning or neural networks. Both case based reasoners and neural networks use cases-but in very different ways. We discuss these differences at length. In particular we examine the role of explanation in existing expert systems methodologies. Because neural networks provide poor explanation facilities, we consider the use of Toulmin argument structures to support explanation (S. Toulmin, 1958). We illustrate our ideas with regard to a number of systems built by the authors

Intelligent design assistant (IDA): a case base reasoning system for material and design

This paper describes the approach to the modelling of experiential knowledge in an industrial application of Case-Based Reasoning (CBR). The CBR involves retrieval techniques in conjunction with a relational database. The database is especially designed as a repository of experiential knowledge, and includes qualitative search indices. The system is intended to help design engineers and material engineers in the submarine cable industry. It consists of three parts: a materials database; a database of experiential knowledge; and a CBR system used to retrieve similar past designs based upon component and material qualitative descriptions. The system is currently undergoing user testing at the Alcatel Submarine Networks site in Greenwich.

A case based model to assist in the design process in the manufacture of furniture products

This paper describes progress on a project to utilise case based reasoning methods in the design and manufacture of furniture products. The novel feature of this research is that cases are represented as structures in a relational database of products, components and materials. The paper proposes a method for extending the usual "weighted sum" over attribute similarities for a ·single table to encompass relational structures over several tables. The capabilities of the system are discussed, particularly with respect to differing user objectives, such as cost estimation, CAD, cutting scheme re-use, and initial design. It is shown that specification of a target case as a relational structure combined with suitable weights can fulfil several user functions. However, it is also shown that some user functions cannot satisfactorily be specified via a single target case. For these functions it is proposed to allow the specification of a set of target cases. A derived similarity measure between individuals and sets of cases is proposed.

Case based adaptation using interpolation over nominal values

In this paper we propose a method for interpolation over a set of retrieved cases in the adaptation phase of the case-based reasoning cycle. The method has two advantages over traditional systems: the first is that it can predict “new” instances, not yet present in the case base; the second is that it can predict solutions not present in the retrieval set. The method is a generalisation of Shepard’s Interpolation method, formulated as the minimisation of an error function defined in terms of distance metrics in the solution and problem spaces. We term the retrieval algorithm the Generalised Shepard Nearest Neighbour (GSNN) method. A novel aspect of GSNN is that it provides a general method for interpolation over nominal solution domains. The method is illustrated in the paper with reference to the Irises classification problem. It is evaluated with reference to a simulated nominal value test problem, and to a benchmark case base from the travel domain. The algorithm is shown to out-perform conventional nearest neighbour methods on these problems. Finally, GSNN is shown to improve in efficiency when used in conjunction with a diverse retrieval algorithm.

A hybrid approach of knowledge-based reasoning for structural assessment

La idea básica de detección de defectos basada en vibraciones en Monitorización de la Salud Estructural (SHM), es que el defecto altera las propiedades de rigidez, masa o disipación de energía de un sistema, el cual, altera la respuesta dinámica del mismo. Dentro del contexto de reconocimiento de patrones, esta tesis presenta una metodología híbrida de razonamiento para evaluar los defectos en las estructuras, combinando el uso de un modelo de la estructura y/o experimentos previos con el esquema de razonamiento basado en el conocimiento para evaluar si el defecto está presente, su gravedad y su localización. La metodología involucra algunos elementos relacionados con análisis de vibraciones, matemáticas (wavelets, control de procesos estadístico), análisis y procesamiento de señales y/o patrones (razonamiento basado en casos, redes auto-organizativas), estructuras inteligentes y detección de defectos. Las técnicas son validadas numérica y experimentalmente considerando corrosión, pérdida de masa, acumulación de masa e impactos. Las estructuras usadas durante este trabajo son: una estructura tipo cercha voladiza, una viga de aluminio, dos secciones de tubería y una parte del ala de un avión comercial.

Case based design of knitwear

In the developed world we are surrounded by man-made objects, but most people give little thought to the complex processes needed for their design. The design of hand knitting is complex because much of the domain knowledge is tacit. The objective of this thesis is to devise a methodology to help designers to work within design constraints, whilst facilitating creativity. A hybrid solution including computer aided design (CAD) and case based reasoning (CBR) is proposed. The CAD system creates designs using domain-specific rules and these designs are employed for initial seeding of the case base and the management of constraints. CBR reuses the designer's previous experience. The key aspects in the CBR system are measuring the similarity of cases and adapting past solutions to the current problem. Similarity is measured by asking the user to rank the importance of features; the ranks are then used to calculate weights for an algorithm which compares the specifications of designs. A novel adaptation operator called rule difference replay (RDR) is created. When the specifications to a new design is presented, the CAD program uses it to construct a design constituting an approximate solution. The most similar design from the case-base is then retrieved and RDR replays the changes previously made to the retrieved design on the new solution. A measure of solution similarity that can validate subjective success scores is created. Specification similarity can be used as a guide whether to invoke CBR, in a hybrid CAD-CBR system. If the newly resulted design is suffciently similar to a previous design, then CBR is invoked; otherwise CAD is used. The application of RDR to knitwear design has demonstrated the flexibility to overcome deficiencies in rules that try to automate creativity, and has the potential to be applied to other domains such as interior design.

Mobile case-based decision support for intelligent patient knowledge management

Hospitals everywhere are integrating health data using electronic health record (EHR) systems, and disparate and multimedia patient data can be input by different caregivers at different locations as encapsulated patient profiles. Healthcare institutions are also using the flexibility and speed of wireless computing to improve quality and reduce costs. We are developing a mobile application that allows doctors to efficiently record and access complete and accurate real-time patient information. The system integrates medical imagery with textual patient profiles as well as expert interactions by healthcare personnel using knowledge management and case-based reasoning techniques. The application can assist other caregivers in searching large repositories of previous patient cases. Patients' symptoms can be input to a portable device and the application can quickly retrieve similar profiles which can be used to support effective diagnoses and prognoses by comparing symptoms, treatments, diagnosis, test results and other patient information. © 2007 Sage Publications.

Case Based Heuristic Selection for Timetabling Problems

This paper presents a case-based heuristic selection approach for automated university course and exam timetabling. The method described in this paper is motivated by the goal of developing timetabling systems that are fundamentally more general than the current state of the art. Heuristics that worked well in previous similar situations are memorized in a case base and are retrieved for solving the problem in hand. Knowledge discovery techniques are employed in two distinct scenarios. Firstly, we model the problem and the problem solving situations along with specific heuristics for those problems. Secondly, we refine the case base and discard cases which prove to be non-useful in solving new problems. Experimental results are presented and analyzed. It is shown that case based reasoning can act effectively as an intelligent approach to learn which heuristics work well for particular timetabling situations. We conclude by outlining and discussing potential research issues in this critical area of knowledge discovery for different difficult timetabling problems.

Case Based Heuristic Selection for Timetabling Problems

This paper presents a case-based heuristic selection approach for automated university course and exam timetabling. The method described in this paper is motivated by the goal of developing timetabling systems that are fundamentally more general than the current state of the art. Heuristics that worked well in previous similar situations are memorized in a case base and are retrieved for solving the problem in hand. Knowledge discovery techniques are employed in two distinct scenarios. Firstly, we model the problem and the problem solving situations along with specific heuristics for those problems. Secondly, we refine the case base and discard cases which prove to be non-useful in solving new problems. Experimental results are presented and analyzed. It is shown that case based reasoning can act effectively as an intelligent approach to learn which heuristics work well for particular timetabling situations. We conclude by outlining and discussing potential research issues in this critical area of knowledge discovery for different difficult timetabling problems.

A Case-Based Approach to Nosocomial Infection Detection

The nosocomial infections are a growing concern because they affect a large number of people and they increase the admission time in healthcare facilities. Additionally, its diagnosis is very tricky, requiring multiple medical exams. So, this work is focused on the development of a clinical decision support system to prevent these events from happening. The proposed solution is unique once it caters for the explicit treatment of incomplete, unknown, or even contradictory information under a logic programming basis, that to our knowledge is something that happens for the first time.

Waiting Time Screening in Diagnostic Medical Imaging - A Case-Based View

Due to the high standards expected from diagnostic medical imaging, the analysis of information regarding waiting lists via different information systems is of utmost importance. Such analysis, on the one hand, may improve the diagnostic quality and, on the other hand, may lead to the reduction of waiting times, with the concomitant increase of the quality of services and the reduction of the inherent financial costs. Hence, the purpose of this study is to assess the waiting time in the delivery of diagnostic medical imaging services, like computed tomography and magnetic resonance imaging. Thereby, this work is focused on the development of a decision support system to assess waiting times in diagnostic medical imaging with recourse to operational data of selected attributes extracted from distinct information systems. The computational framework is built on top of a Logic Programming Case-base Reasoning approach to Knowledge Representation and Reasoning that caters for the handling of in-complete, unknown, or even self-contradictory information.

A Case Based approach to assess Waiting Time Prediction at an Intensive Care Unity

Waiting time at an intensive care unity stands for a key feature in the assessment of healthcare quality. Nevertheless, its estimation is a difficult task, not only due to the different factors with intricate relations among them, but also with respect to the available data, which may be incomplete, self-contradictory or even unknown. However, its prediction not only improves the patients’ satisfaction but also enhance the quality of the healthcare being provided. To fulfill this goal, this work aims at the development of a decision support system that allows one to predict how long a patient should remain at an emergency unit, having into consideration all the remarks that were just stated above. It is built on top of a Logic Programming approach to knowledge representation and reasoning, complemented with a Case Base approach to computing.

Chest Breadths to Predict Individuals' Age - A Case Based View

It is well known that rib cage dimensions depend on the gender and vary with the age of the individual. Under this setting it is therefore possible to assume that a computational approach to the problem may be thought out and, consequently, this work will focus on the development of an Artificial Intelligence grounded decision support system to predict individual’s age, based on such measurements. On the one hand, using some basic image processing techniques it were extracted such descriptions from chest X-rays (i.e., its maximum width and height). On the other hand, the computational framework was built on top of a Logic Programming Case Base approach to knowledge representation and reasoning, which caters for the handling of incomplete, unknown, or even contradictory information. Furthermore, clustering methods based on similarity analysis among cases were used to distinguish and aggregate collections of historical data in order to reduce the search space, therefore enhancing the cases retrieval and the overall computational process. The accuracy of the proposed model is satisfactory, close to 90%.

A Case Based Methodology for Problem Solving aiming at Knee Osteoarthritis Detection

Knee osteoarthritis is the most common type of arthritis and a major cause of impaired mobility and disability for the ageing populations. Therefore, due to the increasing prevalence of the malady, it is expected that clinical and scientific practices had to be set in order to detect the problem in its early stages. Thus, this work will be focused on the improvement of methodologies for problem solving aiming at the development of Artificial Intelligence based decision support system to detect knee osteoarthritis. The framework is built on top of a Logic Programming approach to Knowledge Representation and Reasoning, complemented with a Case Based approach to computing that caters for the handling of incomplete, unknown, or even self-contradictory information.

Using ‘think aloud’ as a strategy for learning clinical reasoning in high fidelity case-based simulation for undergraduate nursing students

AIMS This paper reports on the implementation of a research project that trials an educational strategy implemented over six months of an undergraduate third year nursing curriculum. This project aims to explore the effectiveness of ‘think aloud’ as a strategy for learning clinical reasoning for students in simulated clinical settings. BACKGROUND Nurses are required to apply and utilise critical thinking skills to enable clinical reasoning and problem solving in the clinical setting [1]. Nursing students are expected to develop and display clinical reasoning skills in practice, but may struggle articulating reasons behind decisions about patient care. For students learning to manage complex clinical situations, teaching approaches are required that make these instinctive cognitive processes explicit and clear [2-5]. In line with professional expectations, nursing students in third year at Queensland University of Technology (QUT) are expected to display clinical reasoning skills in practice. This can be a complex proposition for students in practice situations, particularly as the degree of uncertainty or decision complexity increases [6-7]. The ‘think aloud’ approach is an innovative learning/teaching method which can create an environment suitable for developing clinical reasoning skills in students [4, 8]. This project aims to use the ‘think aloud’ strategy within a simulation context to provide a safe learning environment in which third year students are assisted to uncover cognitive approaches that best assist them to make effective patient care decisions, and improve their confidence, clinical reasoning and active critical reflection on their practice. MEHODS In semester 2 2011 at QUT, third year nursing students will undertake high fidelity simulation, some for the first time commencing in September of 2011. There will be two cohorts for strategy implementation (group 1= use think aloud as a strategy within the simulation, group 2= not given a specific strategy outside of nursing assessment frameworks) in relation to problem solving patient needs. Students will be briefed about the scenario, given a nursing handover, placed into a simulation group and an observer group, and the facilitator/teacher will run the simulation from a control room, and not have contact (as a ‘teacher’) with students during the simulation. Then debriefing will occur as a whole group outside of the simulation room where the session can be reviewed on screen. The think aloud strategy will be described to students in their pre-simulation briefing and allow for clarification of this strategy at this time. All other aspects of the simulations remain the same, (resources, suggested nursing assessment frameworks, simulation session duration, size of simulation teams, preparatory materials). RESULTS Methodology of the project and the challenges of implementation will be the focus of this presentation. This will include ethical considerations in designing the project, recruitment of students and implementation of a voluntary research project within a busy educational curriculum which in third year targets 669 students over two campuses. CONCLUSIONS In an environment of increasingly constrained clinical placement opportunities, exploration of alternate strategies to improve critical thinking skills and develop clinical reasoning and problem solving for nursing students is imperative in preparing nurses to respond to changing patient needs. References 1. Lasater, K., High-fidelity simulation and the development of clinical judgement: students' experiences. Journal of Nursing Education, 2007. 46(6): p. 269-276. 2. Lapkin, S., et al., Effectiveness of patient simulation manikins in teaching clinical reasoning skills to undergraduate nursing students: a systematic review. Clinical Simulation in Nursing, 2010. 6(6): p. e207-22. 3. Kaddoura, M.P.C.M.S.N.R.N., New Graduate Nurses' Perceptions of the Effects of Clinical Simulation on Their Critical Thinking, Learning, and Confidence. The Journal of Continuing Education in Nursing, 2010. 41(11): p. 506. 4. Banning, M., The think aloud approach as an educational tool to develop and assess clinical reasoning in undergraduate students. Nurse Education Today, 2008. 28: p. 8-14. 5. Porter-O'Grady, T., Profound change:21st century nursing. Nursing Outlook, 2001. 49(4): p. 182-186. 6. Andersson, A.K., M. Omberg, and M. Svedlund, Triage in the emergency department-a qualitative study of the factors which nurses consider when making decisions. Nursing in Critical Care, 2006. 11(3): p. 136-145. 7. O'Neill, E.S., N.M. Dluhy, and C. Chin, Modelling novice clinical reasoning for a computerized decision support system. Journal of Advanced Nursing, 2005. 49(1): p. 68-77. 8. Lee, J.E. and N. Ryan-Wenger, The "Think Aloud" seminar for teaching clinical reasoning: a case study of a child with pharyngitis. J Pediatr Health Care, 1997. 11(3): p. 101-10.