Retrieving similar cases for clinical decision support in the context of revascularization of lower limbs

Background Vascular surgeons face complex decisions regarding revascularization of lower limbs of patients, for which there is no decision support solution yet available. Objective Relying on Case-Based Reasoning approach, this paper addresses the issue of case retrieving in the context of lower limb revascularization. To this end we propose a similarity measure based on relevant clinical attributes selection and weighting. We analyze its performance for clinical decision support. Method Retrieval process is used to anticipate the success or failure of a revascularization strategy for a new patient based on the surgical procedure outcome of similar past patient cases. Using clinical knowledge in Global vascular Guidelines, cases were structured and formalized. They were described by several attributes reflecting the patient risk estimation, limb pathology staging, localization of atherosclerotic lesions, vascular history …