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Case-Based Reasoning in the Care of Alzheimer’s Disease Patients
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Case-Based Reasoning in the Care of Alzheimer’s Disease Patients
Cindy Marling3 and Peter Whitehouse4 
| (3) |
School of Electrical Engineering and Computer Science, Ohio University, Athens, Ohio 45701, USA |
| (4) |
University Alzheimer Center and School of Medicine, Case Western Reserve University, Cleveland, Ohio 44106, USA |
Abstract
Planning the ongoing care of Alzheimer’s Disease (AD) patients is a complex task, marked by cases that change over time, multiple
perspectives, and ethical issues. Geriatric interdisciplinary teams of physicians, nurses and social workers currently plan
this care without computer assistance. Although AD is incurable, interventions are planned to improve the quality of life
for patients and their families. Much of the reasoning involved is case-based, as clinicians look to case histories to learn
which interventions are effective, to document clinical findings, and to train future health care professionals.
There is great variability among AD patients, and within the same patient over time. AD is not yet well enough understood
for universally effective treatments to be available. The case-based reasoning (CBR) research paradigm complements the medical
research approach of finding treatments effective for all patients by matching patients to treatments that were effective
for similar patients in the past.
The Auguste Project is an effort to provide decision support for planning the ongoing care of AD patients, using CBR and other
thought processes natural to members of geriatric interdisciplinary teams. System prototypes are used to explore the reasoning
processes involved and to provide the forerunners of practical clinical tools. The first system prototype has just been completed.
This prototype supports the decision to prescribe neuroleptic drugs to AD patients with behavioral problems. It uses CBR to
determine if a neuroleptic drug should be prescribed and rule-based reasoning to select one of five approved neuroleptic drugs
for a patient. The first system prototype serves as proof of concept that CBR is useful for planning ongoing care for AD patients.
Additional prototypes are planned to explore the research issues raised.
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