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  • 1.
    Razavi, Amir R
    et al.
    Linköpings universitet, Institutionen för medicinsk teknik, Medicinsk informatik. Linköpings universitet, Tekniska högskolan.
    Gill, Hans
    Linköpings universitet, Institutionen för medicinsk teknik, Medicinsk informatik. Linköpings universitet, Tekniska högskolan.
    Åhlfeldt, Hans
    Linköpings universitet, Institutionen för medicinsk teknik, Medicinsk informatik. Linköpings universitet, Tekniska högskolan.
    Shahsavar, Nosrat
    Linköpings universitet, Institutionen för medicinsk teknik, Medicinsk informatik. Linköpings universitet, Tekniska högskolan.
    Non-compliance with a postmastectomy radiotherapy guideline: Decision tree and cause analysis2008Ingår i: BMC Medical Informatics and Decision Making, E-ISSN 1472-6947, Vol. 8, nr 41Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: The guideline for postmastectomy radiotherapy (PMRT), which is prescribed to reduce recurrence of breast cancer in the chest wall and improve overall survival, is not always followed. Identifying and extracting important patterns of non-compliance are crucial in maintaining the quality of care in Oncology.

    Methods: Analysis of 759 patients with malignant breast cancer using decision tree induction (DTI) found patterns of non-compliance with the guideline. The PMRT guideline was used to separate cases according to the recommendation to receive or not receive PMRT. The two groups of patients were analyzed separately. Resulting patterns were transformed into rules that were then compared with the reasons that were extracted by manual inspection of records for the non-compliant cases.

    Results: Analyzing patients in the group who should receive PMRT according to the guideline did not result in a robust decision tree. However, classification of the other group, patients who should not receive PMRT treatment according to the guideline, resulted in a tree with nine leaves and three of them were representing non-compliance with the guideline. In a comparison between rules resulting from these three non-compliant patterns and manual inspection of patient records, the following was found:

    In the decision tree, presence of perigland growth is the most important variable followed by number of malignantly invaded lymph nodes and level of Progesterone receptor. DNA index, age, size of the tumor and level of Estrogen receptor are also involved but with less importance. From manual inspection of the cases, the most frequent pattern for non-compliance is age above the threshold followed by near cut-off values for risk factors and unknown reasons.

    Conclusion: Comparison of patterns of non-compliance acquired from data mining and manual inspection of patient records demonstrates that not all of the non-compliances are repetitive or important. There are some overlaps between important variables acquired from manual inspection of patient records and data mining but they are not identical. Data mining can highlight non-compliance patterns valuable for guideline authors and for medical audit. Improving guidelines by using feedback from data mining can improve the quality of care in oncology.

    Ladda ner fulltext (pdf)
    FULLTEXT01
  • 2. Beställ onlineKöp publikationen >>
    Razavi, Amir Reza
    Linköpings universitet, Institutionen för medicinsk teknik, Medicinsk informatik. Linköpings universitet, Tekniska högskolan.
    Applications of Knowledge Discovery in Quality Registries - Predicting Recurrence of Breast Cancer and Analyzing Non-compliance with a Clinical Guideline2007Doktorsavhandling, sammanläggning (Övrigt vetenskapligt)
    Abstract [en]

    In medicine, data are produced from different sources and continuously stored in data depositories. Examples of these growing databases are quality registries. In Sweden, there are many cancer registries where data on cancer patients are gathered and recorded and are used mainly for reporting survival analyses to high level health authorities.

    In this thesis, a breast cancer quality registry operating in South-East of Sweden is used as the data source for newer analytical techniques, i.e. data mining as a part of knowledge discovery in databases (KDD) methodology. Analyses are done to sift through these data in order to find interesting information and hidden knowledge. KDD consists of multiple steps, starting with gathering data from different sources and preparing them in data pre-processing stages prior to data mining.

    Data were cleaned from outliers and noise and missing values were handled. Then a proper subset of the data was chosen by canonical correlation analysis (CCA) in a dimensionality reduction step. This technique was chosen because there were multiple outcomes, and variables had complex relationship to one another.

    After data were prepared, they were analyzed with a data mining method. Decision tree induction as a simple and efficient method was used to mine the data. To show the benefits of proper data pre-processing, results from data mining with pre-processing of the data were compared with results from data mining without data pre-processing. The comparison showed that data pre-processing results in a more compact model with a better performance in predicting the recurrence of cancer.

    An important part of knowledge discovery in medicine is to increase the involvement of medical experts in the process. This starts with enquiry about current problems in their field, which leads to finding areas where computer support can be helpful. The experts can suggest potentially important variables and should then approve and validate new patterns or knowledge as predictive or descriptive models. If it can be shown that the performance of a model is comparable to domain experts, it is more probable that the model will be used to support physicians in their daily decision-making. In this thesis, we validated the model by comparing predictions done by data mining and those made by domain experts without finding any significant difference between them.

    Breast cancer patients who are treated with mastectomy are recommended to receive radiotherapy. This treatment is called postmastectomy radiotherapy (PMRT) and there is a guideline for prescribing it. A history of this treatment is stored in breast cancer registries. We analyzed these datasets using rules from a clinical guideline and identified cases that had not been treated according to the PMRT guideline. Data mining revealed some patterns of non-compliance with the PMRT guideline. Further analysis with data mining revealed some reasons for guideline non-compliance. These patterns were then compared with reasons acquired from manual inspection of patient records. The comparisons showed that patterns resulting from data mining were limited to the stored variables in the registry. A prerequisite for better results is availability of comprehensive datasets.

    Medicine can take advantage of KDD methodology in different ways. The main advantage is being able to reuse information and explore hidden knowledge that can be obtained using advanced analysis techniques. The results depend on good collaboration between medical informaticians and domain experts and the availability of high quality data.

    Delarbeten
    1. Exploring cancer register data to find risk factors for recurrence of breast cancer: Application of Canonical Correlation Analysis
    Öppna denna publikation i ny flik eller fönster >>Exploring cancer register data to find risk factors for recurrence of breast cancer: Application of Canonical Correlation Analysis
    Visa övriga...
    2005 (Engelska)Ingår i: BMC Medical Informatics and Decision Making, ISSN 1472-6947, Vol. 5, nr 29, s. 29-35Artikel i tidskrift (Refereegranskat) Published
    Abstract [en]

    Background

    A common approach in exploring register data is to find relationships between outcomes and predictors by using multiple regression analysis (MRA). If there is more than one outcome variable, the analysis must then be repeated, and the results combined in some arbitrary fashion. In contrast, Canonical Correlation Analysis (CCA) has the ability to analyze multiple outcomes at the same time.

    One essential outcome after breast cancer treatment is recurrence of the disease. It is important to understand the relationship between different predictors and recurrence, including the time interval until recurrence. This study describes the application of CCA to find important predictors for two different outcomes for breast cancer patients, loco-regional recurrence and occurrence of distant metastasis and to decrease the number of variables in the sets of predictors and outcomes without decreasing the predictive strength of the model.

    Methods

    Data for 637 malignant breast cancer patients admitted in the south-east region of Sweden were analyzed. By using CCA and looking at the structure coefficients (loadings), relationships between tumor specifications and the two outcomes during different time intervals were analyzed and a correlation model was built.

    Results

    The analysis successfully detected known predictors for breast cancer recurrence during the first two years and distant metastasis 2–4 years after diagnosis. Nottingham Histologic Grading (NHG) was the most important predictor, while age of the patient at the time of diagnosis was not an important predictor.

    Conclusion

    In cancer registers with high dimensionality, CCA can be used for identifying the importance of risk factors for breast cancer recurrence. This technique can result in a model ready for further processing by data mining methods through reducing the number of variables to important ones.

    Nationell ämneskategori
    Medicin och hälsovetenskap
    Identifikatorer
    urn:nbn:se:liu:diva-12706 (URN)10.1186/1472-6947-5-29 (DOI)
    Tillgänglig från: 2009-02-22 Skapad: 2008-10-24 Senast uppdaterad: 2009-03-10Bibliografiskt granskad
    2. A Data Pre-processing Method to Increase Efficiency and Accuracy in Data Mining
    Öppna denna publikation i ny flik eller fönster >>A Data Pre-processing Method to Increase Efficiency and Accuracy in Data Mining
    2005 (Engelska)Ingår i: 10th Conference on Artificial Intelligence in Medicine, AIME2005 - Aberdeen, UK / [ed] Miksch, Silvia, Hunter, Jim, Keravnou, Elpida, 2005, s. 434-443Konferensbidrag, Publicerat paper (Övrigt vetenskapligt)
    Abstract [en]

    In medicine, data mining methods such as Decision Tree Induction (DTI) can be trained for extracting rules to predict the outcomes of new patients. However, incompleteness and high dimensionality of stored data are a problem. Canonical Correlation Analysis (CCA) can be used prior to DTI as a dimension reduction technique to preserve the character of the original data by omitting non-essential data. In this study, data from 3949 breast cancer patients were analysed. Raw data were cleaned by running a set of logical rules. Missing values were replaced using the Expectation Maximization algorithm. After dimension reduction with CCA, DTI was employed to analyse the resulting dataset. The validity of the predictive model was confirmed by ten-fold cross validation and the effect of pre-processing was analysed by applying DTI to data without pre-processing. Replacing missing values and using CCA for data reduction dramatically reduced the size of the resulting tree and increased the accuracy of the prediction of breast cancer recurrence.

    Serie
    Lecture Notes in Computer Science, ISSN 0302-9743, E-ISSN 1611-3349 ; 3581
    Nationell ämneskategori
    Teknik och teknologier
    Identifikatorer
    urn:nbn:se:liu:diva-12707 (URN)10.1007/11527770_59 (DOI)978-3-540-27831-3 (ISBN)
    Konferens
    10th Conference on Artificial Intelligence in Medicine, AIME2005 - Aberdeen, UK
    Tillgänglig från: 2007-10-30 Skapad: 2007-10-30 Senast uppdaterad: 2018-02-20
    3. Predicting metastasis in breast cancer: comparing a decision tree with domain experts
    Öppna denna publikation i ny flik eller fönster >>Predicting metastasis in breast cancer: comparing a decision tree with domain experts
    2007 (Engelska)Ingår i: Journal of Medical Systems, ISSN 0148-5598, Vol. 31, nr 4, s. 263-273Artikel i tidskrift (Refereegranskat) Published
    Abstract [en]

    Breast malignancy is the second most common cause of cancer death among women in Western countries. Identifying high-risk patients is vital in order to provide them with specialized treatment. In some situations, such as when access to experienced oncologists is not possible, decision support methods can be helpful in predicting the recurrence of cancer. Three thousand six hundred ninety-nine breast cancer patients admitted in south-east Sweden from 1986 to 1995 were studied. A decision tree was trained with all patients except for 100 cases and tested with those 100 cases. Two domain experts were asked for their opinions about the probability of recurrence of a certain outcome for these 100 patients. ROC curves, area under the ROC curves, and calibration for predictions were computed and compared. After comparing the predictions from a model built by data mining with predictions made by two domain experts, no significant differences were noted. In situations where experienced oncologists are not available, predictive models created with data mining techniques can be used to support physicians in decision making with acceptable accuracy.

    Nyckelord
    Data mining, Decision tree induction (DTI), Breast cancer, Classification, Prediction, Domain expert, Decision support
    Nationell ämneskategori
    Biomedicinsk laboratorievetenskap/teknologi
    Identifikatorer
    urn:nbn:se:liu:diva-12708 (URN)10.1007/s10916-007-9064-1 (DOI)
    Tillgänglig från: 2007-10-30 Skapad: 2007-10-30 Senast uppdaterad: 2009-05-12
    4. A Data Mining Approach to Analyze Non-compliance with a Guideline for the Treatment of Breast Cancer
    Öppna denna publikation i ny flik eller fönster >>A Data Mining Approach to Analyze Non-compliance with a Guideline for the Treatment of Breast Cancer
    2007 (Engelska)Ingår i: Studies in Health Technology and Informatics, ISSN 0926-9630, E-ISSN 1879-8365, Vol. 129, s. 591-597Artikel i tidskrift (Refereegranskat) Published
    Abstract [en]

    Postmastectomy radiotherapy (PMRT) is prescribed in order to reduce the local recurrence of breast cancer and improve overall survival. A guideline supports the trade-off between benefits and adverse effects of PMRT. However, this guideline is not always followed in practice. This study tries to find a method for revealing patterns of non-compliance between the actual treatment and the PMRT guideline.

    Data from breast cancer patients admitted to Linköping University Hospital between 1990 and 2000 were analyzed in this study. Cases that were not treated in accordance with the guideline were selected and analyzed by decision tree induction (DTI). Thereafter, four resulting rules, as representations for groups of patients, were compared to the guideline.

    Finding patterns of non-compliance with guidelines by means of rules can be an appropriate alternative to manual methods, i.e. a case-by-case comparison when studying very large datasets. The resulting rules can be used in a knowledge base of a guideline-based decision support system to alert when inconsistencies with the guidelines may appear.

    Nationell ämneskategori
    Biomedicinsk laboratorievetenskap/teknologi
    Identifikatorer
    urn:nbn:se:liu:diva-12709 (URN)
    Tillgänglig från: 2007-10-30 Skapad: 2007-10-30 Senast uppdaterad: 2017-12-14
    5. Non-compliance with a postmastectomy radiotherapy guideline: Decision tree and cause analysis
    Öppna denna publikation i ny flik eller fönster >>Non-compliance with a postmastectomy radiotherapy guideline: Decision tree and cause analysis
    2008 (Engelska)Ingår i: BMC Medical Informatics and Decision Making, E-ISSN 1472-6947, Vol. 8, nr 41Artikel i tidskrift (Refereegranskat) Published
    Abstract [en]

    Background: The guideline for postmastectomy radiotherapy (PMRT), which is prescribed to reduce recurrence of breast cancer in the chest wall and improve overall survival, is not always followed. Identifying and extracting important patterns of non-compliance are crucial in maintaining the quality of care in Oncology.

    Methods: Analysis of 759 patients with malignant breast cancer using decision tree induction (DTI) found patterns of non-compliance with the guideline. The PMRT guideline was used to separate cases according to the recommendation to receive or not receive PMRT. The two groups of patients were analyzed separately. Resulting patterns were transformed into rules that were then compared with the reasons that were extracted by manual inspection of records for the non-compliant cases.

    Results: Analyzing patients in the group who should receive PMRT according to the guideline did not result in a robust decision tree. However, classification of the other group, patients who should not receive PMRT treatment according to the guideline, resulted in a tree with nine leaves and three of them were representing non-compliance with the guideline. In a comparison between rules resulting from these three non-compliant patterns and manual inspection of patient records, the following was found:

    In the decision tree, presence of perigland growth is the most important variable followed by number of malignantly invaded lymph nodes and level of Progesterone receptor. DNA index, age, size of the tumor and level of Estrogen receptor are also involved but with less importance. From manual inspection of the cases, the most frequent pattern for non-compliance is age above the threshold followed by near cut-off values for risk factors and unknown reasons.

    Conclusion: Comparison of patterns of non-compliance acquired from data mining and manual inspection of patient records demonstrates that not all of the non-compliances are repetitive or important. There are some overlaps between important variables acquired from manual inspection of patient records and data mining but they are not identical. Data mining can highlight non-compliance patterns valuable for guideline authors and for medical audit. Improving guidelines by using feedback from data mining can improve the quality of care in oncology.

    Nationell ämneskategori
    Medicin och hälsovetenskap
    Identifikatorer
    urn:nbn:se:liu:diva-15222 (URN)
    Anmärkning
    Original publication: Amir R Razavi, Hans Gill, Hans Åhlfeldt and Nosrat Shahsavar, Non-compliance with a postmastectomy radiotherapy guideline: Decision tree and cause analysis, 2008, BMC Medical Informatics and Decision Making, (8), 41.http://dx.doi.org/10.1186/1472-6947-8-41. Copyright: The authorsTillgänglig från: 2008-10-24 Skapad: 2008-10-24 Senast uppdaterad: 2022-05-10Bibliografiskt granskad
    Ladda ner fulltext (pdf)
    FULLTEXT01
    Ladda ner (pdf)
    COVER01
  • 3.
    Razavi, Amir Reza
    et al.
    Linköpings universitet, Institutionen för medicinsk teknik, Medicinsk informatiK. Linköpings universitet, Tekniska högskolan.
    Gill, Hans
    Linköpings universitet, Institutionen för medicinsk teknik, Medicinsk informatiK. Linköpings universitet, Tekniska högskolan.
    Stål, Olle
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Onkologi. Linköpings universitet, Hälsouniversitetet.
    Sundquist, Marie
    Department of Surgery, County Hospital, Kalmar, Sweden.
    Thorstenson, Sten
    Department of Pathology, County Hospital, Kalmar, Sweden.
    Åhlfeldt, Hans
    Linköpings universitet, Institutionen för medicinsk teknik, Medicinsk informatiK. Linköpings universitet, Tekniska högskolan.
    Shahsavar, Nosrat
    Linköpings universitet, Institutionen för medicinsk teknik, Medicinsk informatiK. Linköpings universitet, Tekniska högskolan.
    The South-East Swedish Breast Cancer Study Group,
    Exploring cancer register data to find risk factors for recurrence of breast cancer: Application of Canonical Correlation Analysis2005Ingår i: BMC Medical Informatics and Decision Making, ISSN 1472-6947, Vol. 5, nr 29, s. 29-35Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background

    A common approach in exploring register data is to find relationships between outcomes and predictors by using multiple regression analysis (MRA). If there is more than one outcome variable, the analysis must then be repeated, and the results combined in some arbitrary fashion. In contrast, Canonical Correlation Analysis (CCA) has the ability to analyze multiple outcomes at the same time.

    One essential outcome after breast cancer treatment is recurrence of the disease. It is important to understand the relationship between different predictors and recurrence, including the time interval until recurrence. This study describes the application of CCA to find important predictors for two different outcomes for breast cancer patients, loco-regional recurrence and occurrence of distant metastasis and to decrease the number of variables in the sets of predictors and outcomes without decreasing the predictive strength of the model.

    Methods

    Data for 637 malignant breast cancer patients admitted in the south-east region of Sweden were analyzed. By using CCA and looking at the structure coefficients (loadings), relationships between tumor specifications and the two outcomes during different time intervals were analyzed and a correlation model was built.

    Results

    The analysis successfully detected known predictors for breast cancer recurrence during the first two years and distant metastasis 2–4 years after diagnosis. Nottingham Histologic Grading (NHG) was the most important predictor, while age of the patient at the time of diagnosis was not an important predictor.

    Conclusion

    In cancer registers with high dimensionality, CCA can be used for identifying the importance of risk factors for breast cancer recurrence. This technique can result in a model ready for further processing by data mining methods through reducing the number of variables to important ones.

    Ladda ner fulltext (pdf)
    FULLTEXT01
  • 4.
    Razavi, Amir Reza
    et al.
    Linköpings universitet, Institutionen för medicinsk teknik, Medicinsk informatik. Linköpings universitet, Tekniska högskolan.
    Gill, Hans
    Linköpings universitet, Institutionen för medicinsk teknik, Medicinsk informatik. Linköpings universitet, Tekniska högskolan.
    Åhlfeldt, Hans
    Linköpings universitet, Institutionen för medicinsk teknik, Medicinsk informatik. Linköpings universitet, Tekniska högskolan.
    Shahsavar, Nosrat
    Linköpings universitet, Institutionen för medicinsk teknik, Medicinsk informatik. Linköpings universitet, Tekniska högskolan.
    A Data Mining Approach to Analyze Non-compliance with a Guideline for the Treatment of Breast Cancer2007Ingår i: Studies in Health Technology and Informatics, ISSN 0926-9630, E-ISSN 1879-8365, Vol. 129, s. 591-597Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Postmastectomy radiotherapy (PMRT) is prescribed in order to reduce the local recurrence of breast cancer and improve overall survival. A guideline supports the trade-off between benefits and adverse effects of PMRT. However, this guideline is not always followed in practice. This study tries to find a method for revealing patterns of non-compliance between the actual treatment and the PMRT guideline.

    Data from breast cancer patients admitted to Linköping University Hospital between 1990 and 2000 were analyzed in this study. Cases that were not treated in accordance with the guideline were selected and analyzed by decision tree induction (DTI). Thereafter, four resulting rules, as representations for groups of patients, were compared to the guideline.

    Finding patterns of non-compliance with guidelines by means of rules can be an appropriate alternative to manual methods, i.e. a case-by-case comparison when studying very large datasets. The resulting rules can be used in a knowledge base of a guideline-based decision support system to alert when inconsistencies with the guidelines may appear.

  • 5.
    Razavi, Amir Reza
    et al.
    Linköpings universitet, Tekniska högskolan. Linköpings universitet, Institutionen för medicinsk teknik, Medicinsk informatik.
    Gill, Hans
    Linköpings universitet, Tekniska högskolan. Linköpings universitet, Institutionen för medicinsk teknik, Medicinsk informatik.
    Åhlfeldt, Hans
    Linköpings universitet, Tekniska högskolan. Linköpings universitet, Institutionen för medicinsk teknik, Medicinsk informatik.
    Shahsavar, Nosrat
    Linköpings universitet, Tekniska högskolan. Linköpings universitet, Institutionen för medicinsk teknik, Medicinsk informatik.
    A data mining approach to build a predictive model for breast cancer recurrence2006Ingår i: Annual Workshop of the Swedish Intelligence Society SAIS2006,2006, 2006, s. 51-55Konferensbidrag (Övrigt vetenskapligt)
    Abstract [en]

        

  • 6.
    Razavi, Amir Reza
    et al.
    Linköpings universitet, Institutionen för medicinsk teknik, Medicinsk informatik. Linköpings universitet, Tekniska högskolan.
    Gill, Hans
    Linköpings universitet, Institutionen för medicinsk teknik, Medicinsk informatik. Linköpings universitet, Tekniska högskolan.
    Åhlfeldt, Hans
    Linköpings universitet, Institutionen för medicinsk teknik, Medicinsk informatik. Linköpings universitet, Tekniska högskolan.
    Shahsavar, Nosrat
    Linköpings universitet, Institutionen för medicinsk teknik, Medicinsk informatik. Linköpings universitet, Tekniska högskolan.
    A Data Pre-processing Method to Increase Efficiency and Accuracy in Data Mining2005Ingår i: 10th Conference on Artificial Intelligence in Medicine, AIME2005 - Aberdeen, UK / [ed] Miksch, Silvia, Hunter, Jim, Keravnou, Elpida, 2005, s. 434-443Konferensbidrag (Övrigt vetenskapligt)
    Abstract [en]

    In medicine, data mining methods such as Decision Tree Induction (DTI) can be trained for extracting rules to predict the outcomes of new patients. However, incompleteness and high dimensionality of stored data are a problem. Canonical Correlation Analysis (CCA) can be used prior to DTI as a dimension reduction technique to preserve the character of the original data by omitting non-essential data. In this study, data from 3949 breast cancer patients were analysed. Raw data were cleaned by running a set of logical rules. Missing values were replaced using the Expectation Maximization algorithm. After dimension reduction with CCA, DTI was employed to analyse the resulting dataset. The validity of the predictive model was confirmed by ten-fold cross validation and the effect of pre-processing was analysed by applying DTI to data without pre-processing. Replacing missing values and using CCA for data reduction dramatically reduced the size of the resulting tree and increased the accuracy of the prediction of breast cancer recurrence.

  • 7.
    Razavi, Amir Reza
    et al.
    Linköpings universitet, Tekniska högskolan. Linköpings universitet, Institutionen för medicinsk teknik, Medicinsk informatik.
    Gill, Hans
    Linköpings universitet, Tekniska högskolan. Linköpings universitet, Institutionen för medicinsk teknik, Medicinsk informatik.
    Åhlfeldt, Hans
    Linköpings universitet, Tekniska högskolan. Linköpings universitet, Institutionen för medicinsk teknik, Medicinsk informatik.
    Shahsavar, Nosrat
    Linköpings universitet, Tekniska högskolan. Linköpings universitet, Institutionen för medicinsk teknik, Medicinsk informatik.
    Canonical correlation analysis for data reduction in data mining applied to predictive models for breast cancer recurrence2005Ingår i: The XIXth International Congress of the European Federation for Medical Informatics,2005, Amsterdam: IOSPress , 2005, s. 175-180Konferensbidrag (Refereegranskat)
    Abstract [en]

    Data mining methods can be used for extracting specific medical knowledge such as important predictors for recurrence of breast cancer in pertinent data material. However, when there is a huge quantity of variables in the data material it is first necessary to identify and select important variables. In this study we present a preprocessing method for selecting important variables in a dataset prior to building a predictive model. In the dataset, data from 5787 female patients were, analysed. To cover more predictors and obtain a better assessment of the outcomes, data were retrieved from three different registers: the regional breast cancer, tumour markers, and cause of death registers. After retrieving information about selected predictors and outcomes from the different registers, the raw data were cleaned by running different logical rules. Thereafter, domain experts selected predictors assumed to be important regarding recurrence of breast cancer. After that, Canonical Correlation Analysis (CCA) was applied as a dimension reduction technique to preserve the character of the original data. Artificial Neural Network (ANN) was applied to the resulting dataset for two different analyses with the same settings. Performance of the predictive models was confirmed by ten-fold cross validation. The results showed an increase in the accuracy of the prediction and reduction of the mean absolute error.

  • 8.
    Razavi, Amir Reza
    et al.
    Linköpings universitet, Tekniska högskolan. Linköpings universitet, Institutionen för medicinsk teknik, Medicinsk informatik.
    Gill, Hans
    Linköpings universitet, Tekniska högskolan. Linköpings universitet, Institutionen för medicinsk teknik, Medicinsk informatik.
    Åhlfeldt, Hans
    Linköpings universitet, Tekniska högskolan. Linköpings universitet, Institutionen för medicinsk teknik, Medicinsk informatik.
    Shahsavar, Nosrat
    Linköpings universitet, Tekniska högskolan. Linköpings universitet, Institutionen för medicinsk teknik, Medicinsk informatik.
    Data Mining Approach to Analyze Non-compliance with a Guideline for the Treatment of Breast Cancer2007Ingår i: MEDINFO 2007: PROCEEDINGS OF THE 12TH WORLD CONGRESS ON HEALTH (MEDICAL) INFORMATICS, PTS 1 AND 2, IOS Press, 2007, s. 591-595Konferensbidrag (Refereegranskat)
    Abstract [en]

    Postmastectomy radiotherapy (PAMT) is prescribed in order to reduce the local recurrence of breast cancer and improve overall survival. A guideline supports the trade-off between benefits and adverse effects of PMRT However, this guideline is not always followed in practice. This study tries to find a method for revealing patterns of noncompliance between the actual treatment and the PMRT guideline.Data from breast cancer patients admitted to Linkoping University Hospital between 1990 and 2000 were analyzed in this study. Cases that were not treated in accordance with the guideline were selected and analyzed by decision tree induction (DTI). Thereafter, four resulting rules, as representations for groups of patients, were compared to the guideline.Finding patterns of non-compliance with guidelines by means of rules can be an appropriate alternative to manual methods, i.e. a case-by-case comparison when studying very large datasets. The resulting rules can be used in a knowledge base of a guideline-based decision support system to alert when inconsistencies with the guidelines may appear.

  • 9.
    Razavi, Amir Reza
    et al.
    Linköpings universitet, Institutionen för medicinsk teknik, Medicinsk informatik. Linköpings universitet, Tekniska högskolan.
    Gill, Hans
    Linköpings universitet, Institutionen för medicinsk teknik, Medicinsk informatik. Linköpings universitet, Tekniska högskolan.
    Åhlfeldt, Hans
    Linköpings universitet, Institutionen för medicinsk teknik, Medicinsk informatik. Linköpings universitet, Tekniska högskolan.
    Shahsavar, Nosrat
    Linköpings universitet, Institutionen för medicinsk teknik, Medicinsk informatik. Linköpings universitet, Tekniska högskolan.
    Predicting metastasis in breast cancer: comparing a decision tree with domain experts2007Ingår i: Journal of Medical Systems, ISSN 0148-5598, Vol. 31, nr 4, s. 263-273Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Breast malignancy is the second most common cause of cancer death among women in Western countries. Identifying high-risk patients is vital in order to provide them with specialized treatment. In some situations, such as when access to experienced oncologists is not possible, decision support methods can be helpful in predicting the recurrence of cancer. Three thousand six hundred ninety-nine breast cancer patients admitted in south-east Sweden from 1986 to 1995 were studied. A decision tree was trained with all patients except for 100 cases and tested with those 100 cases. Two domain experts were asked for their opinions about the probability of recurrence of a certain outcome for these 100 patients. ROC curves, area under the ROC curves, and calibration for predictions were computed and compared. After comparing the predictions from a model built by data mining with predictions made by two domain experts, no significant differences were noted. In situations where experienced oncologists are not available, predictive models created with data mining techniques can be used to support physicians in decision making with acceptable accuracy.

  • 10.
    Razavi, Amir Reza
    et al.
    Linköpings universitet, Tekniska högskolan. Linköpings universitet, Institutionen för medicinsk teknik, Medicinsk informatik.
    Nyström, Mikael
    Linköpings universitet, Institutionen för medicinsk teknik, Medicinsk informatik. Linköpings universitet, Tekniska högskolan.
    Stachowicz, Marian S.
    Linköpings universitet, Institutionen för medicinsk teknik, Medicinsk informatik. Linköpings universitet, Tekniska högskolan.
    Gill, Hans
    Linköpings universitet, Institutionen för medicinsk teknik, Medicinsk informatik. Linköpings universitet, Tekniska högskolan.
    Åhlfeldt, Hans
    Linköpings universitet, Institutionen för medicinsk teknik, Medicinsk informatik. Linköpings universitet, Tekniska högskolan.
    Shahsavar, Nosrat
    Linköpings universitet, Institutionen för medicinsk teknik, Medicinsk informatik. Linköpings universitet, Tekniska högskolan.
    An approach for generating fuzzy rules from decision trees2006Ingår i: Ubiquity: Technologies for Better Health in Aging Societies - Proceedings of MIE2006 / [ed] Arie Hasman, Reinhold Haux, Johan van der Lei, Etienne De Clercq, Francis Roger-France, IOS Press , 2006, s. 581-586Konferensbidrag (Refereegranskat)
    Abstract [en]

    Identifying high-risk breast cancer patients is vital both for clinicians and for patients. Some variables for identifying these patients such as tumor size are good candidates for fuzzification. In this study, Decision Tree Induction (DTI) has been applied to 3949 female breast cancer patients and crisp If-Then rules has been acquired from the resulting tree. After assigning membership functions for each variable in the crisp rules, they were converted into fuzzy rules and a mathematical model was constructed. One hundred randomly selected cases were examined by this model and compared with crisp rules predictions. The outcomes were examined by the area under the ROC curve (AUC). No significant difference was noticed between these two approaches for prediction of recurrence of breast cancer. By soft discretization of variables according to resulting rules from DTI, a predictive model, which is both more robust to noise and more comprehensible for clinicians, can be built.

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