Combining data mining and case-based reasoning for intelligent decision support for pathology ordering by general practitioners

Pathology ordering by general practitioners (GPs) is a significant contributor to rising health care costs both in Australia and worldwide. A thorough understanding of the nature and patterns of pathology utilization is an essential requirement for effective decision support for pathology ordering. In this paper a novel methodology for integrating data mining and case-based reasoning for decision support for pathology ordering is proposed. It is demonstrated how this methodology can facilitate intelligent decision support that is both patient-oriented and deeply rooted in practical peer-group evidence. Comprehensive data collected by professional pathology companies provide a system-wide profile of patient-specific pathology requests by various GPs as opposed to that limited to an individual GP practice. Using the real data provided by XYZ Pathology Company in Australia that contain more than 1.5 million records of pathology requests by general practitioners (GPs), we illustrate how knowledge extracted from these data through data mining with Kohonen's self-organizing maps constitutes the base that, with further assistance of modern data visualization tools and on-line processing interfaces, can provide "peer-group consensus" evidence support for solving new cases of pathology test ordering problem. The conclusion is that the formal methodology that integrates case-based reasoning principles which are inherently close to GPs' daily practice, and data-driven computationally intensive knowledge discovery mechanisms which can be applied to massive amounts of the pathology requests data routinely available at professional pathology companies, can facilitate more informed evidential decision making by doctors in the area of pathology ordering.