A decision support system for cost-effective diagnosis

Speed, cost, and accuracy are three important goals in disease diagnosis. This paper proposes a machine learning-based expert system algorithm to optimize these goals and assist diagnostic decisions in a sequential decision-making setting.

The algorithm consists of three components that work together to identify the sequence of diagnostic tests that attains the treatment or no test threshold probability for a query case with adequate certainty: lazy-learning classifiers, confident diagnosis, and locally sequential feature selection (LSFS). Speed-based and cost-based objective functions can be used as criteria to select tests.

Results of four different datasets are consistent. All LSFS functions significantly reduce tests and costs. Average cost savings for heart disease, thyroid disease, diabetes, and hepatitis datasets are 50%, 57%, 22%, and 34%, respectively. Average test savings are 55%, 73%, 24%, and 39%, respectively. Accuracies are similar to or better than the baseline (the classifier that uses all available tests in the dataset).

We have demonstrated a new approach that dynamically estimates and determines the optimal sequence of tests that provides the most information (or disease probability) based on a patient's available information.