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Objective: Case-based reasoning (CBR) is a problem-solving paradigm that uses past knowledge to interpret or solve new problems. It is suitable for experience-based and theory-less problems. Building a semantically intelligent CBR that mimic the expert thinking can solve many problems especially medical ones.Methods: Knowledge-intensive CBR using formal ontologies is an evolvement of this paradigm. Ontologies can be used for case representation and storage, and it can be used as a background knowledge. Using standard medical ontologies, such as SNOMED CT, enhances the interoperability and integration with the health care systems. Moreover, utilizing vague or imprecise knowledge further improves the CBR semantic effectiveness. This paper proposes a fuzzy ontology-based CBR framework. It proposes a fuzzy case-base OWL2 ontology, and a fuzzy semantic retrieval algorithm that handles many feature types.Material: This framework is implemented and tested on the diabetes diagnosis problem. The fuzzy ontology is populated with 60 real diabetic cases. The effectiveness of the proposed approach is illustrated with a set of experiments and case studies.Results: The resulting system can answer complex medical queries related to semantic understanding of medical concepts and handling of vague terms. The resulting fuzzy case-base ontology has 63 concepts, 54 (fuzzy) object properties, 138 (fuzzy) datatype properties, 105 fuzzy datatypes, and 2640 instances. The system achieves an accuracy of 97.67%. We compare our framework with existing CBR systems and a set of five machine-learning classifiers; our system outperforms all of these systems.Conclusion: Building an integrated CBR system can improve its performance. Representing CBR knowledge using the fuzzy ontology and building a case retrieval algorithm that treats different features differently improves the accuracy of the resulting systems. [ABSTRACT FROM AUTHOR]

Abstract: Objectives: Balancing the trade-offs between solution quality, problem-solving efficiency, and transparency is an important challenge in medical applications of conversational case-based reasoning (CCBR). For example, test selection in CCBR is often based on strategies in which the absence of a specific hypothesis (e.g., diagnosis) to be confirmed makes it difficult to explain the relevance of test results that users are asked to provide. In this paper, we present an approach to CCBR in medical classification and diagnosis that aims to increase transparency while also providing high levels of accuracy and efficiency. Methods: We present an algorithm for CCBR called iNN(k) in which feature selection is driven by the goal of confirming a target class and informed by a measure of a feature''s discriminating power in favor of the target class. As we demonstrate in a CCBR system called CBR-Confirm, this enables a CCBR system to explain the relevance of any question it asks the user. We evaluate the algorithm''s accuracy and efficiency on a selection of datasets related to medicine and health care. Results: The performance of iNN(k) on a given dataset is shown to depend on the value of k and on whether local or global feature selection is used in the algorithm. The combination of these parameters for which iNN(k) is most effective in addressing the trade-off between accuracy and efficiency is identified for each of the selected datasets. For example, only 42% and 51% on average of features in a complete problem description were needed by iNN(k) to provide accuracy levels of 86.5% and 84.3% respectively on the lymphography and SPECT heart datasets from the UCI machine learning repository. Conclusion: Our results demonstrate the ability of iNN(k) to provide high levels of accuracy on most of the selected datasets, while often requiring the user to provide only a small subset of the features in a complete problem description, and enabling a CCBR system to explain the relevance of any question it asks the user. [Copyright &y& Elsevier]