Case-Based Reasoning Investigation of Therapy Inefficacy

In this paper, we present ISOR, a Case-Based Reasoning system for long-term therapy support in the endocrine domain and in psychiatry. ISOR performs typical therapeutic tasks, such as computing initial therapies, initial dose recommendations, and dose updates. Apart from these tasks ISOR deals especially with situations where therapies become ineffective. Causes for inefficacy have to be found and better therapy recommendations should be computed. In addition to the typical Case-Based Reasoning knowledge, namely former already solved cases, ISOR uses further knowledge forms, especially medical histories of query patients themselves and prototypical cases (prototypes). Furthermore, the knowledge base consists of therapies, conflicts, instructions etc. So, retrieval does not only provide former similar cases but different forms and steps of retrieval are performed, while adaptation occurs as an interactive dialog with the user. Since therapy inefficacy can be caused by various circumstances, we propose searching for former similar cases to get ideas about probable reasons that subsequently should be carefully investigated. We show that ISOR is able to successfully support such investigations.