Addressing Design Issues in Medical Expert System for Low Back Pain Management: Knowledge Representation, Inference Mechanism, and Conflict Resolution Using Bayesian Network

Abstract

Aiming at developing a medical expert system for low back pain management, the paper proposes an efficient knowledge representation scheme using frame data structures, and also derives a reliable resolution logic through Bayesian Network. When a patient comes to the intended expert system for diagnosis, the proposed inference engine outputs a number of probable diseases in sorted order, with each disease being associated with a numeric measure to indicate its possibility of occurrence. When two or more diseases in the list have the same or closer possibility of occurrence, Bayesian Network is used for conflict resolution. The proposed scheme has been validated with cases of empirically selected thirty patients. Considering the expected value 0.75 as level of acceptance, the proposed system offers the diagnostic inference with the standard deviation of 0.029. The computational value of Chi-Squared test has been obtained as 11.08 with 12 degree of freedom, implying that the derived results from the designed system conform the homogeneity with the expected outcomes. Prior to any clinical investigations on the selected low back pain patients, the accuracy level (average) of 73.89% has been achieved by the proposed system, which is quite close to the expected clinical accuracy level of 75%.