A case-based consiliarius for therapy recommendation (ICONS): computer-based advice for calculated antibiotic therapy...

We report here on the system ICONS which utilizes case-based reasoning for medical decision support. As an application domain we have chosen the medical field of 'calculated antibiotic therapy' in an intensive care medicine setting. The system ICONS which runs on a personal computer suggests adequate antibiotic therapy regimen satisfying medical and economic conditions. To speed up the process of finding an adequate antibiotic therapy for a current patient, case-based reasoning is used for finding previously documented similar cases and for modifying them according to the requirements of the current patient. To reduce the memory capacity for the documentation of cases, collections of similar cases are clustered to prototypes. Medical knowledge is represented within a hierarchy of such prototypes and cases and an additional context-sensitive background knowledge-base. A knowledge acquisition tool was programmed that allows revisions of the background medical knowledge-base by simple and comprehensive methods. In addition to the advantage of producing site-specific and time-dependent knowledge, case-based reasoning is a practical method for speeding-up the process of generating and evaluating hypotheses in medical classification tasks.