9. Disease Models, Part II: Querying & Applications

In the previous chapter, the mathematical formalisms that allow us to encode medical knowledge into graphical models were described. Here, we focus on how users can interact with these models (specifically, belief networks) to pose a wide range of questions and understand inferred results - an essential part of the healthcare process as patients and healthcare providers make decisions. Two general classes of queries are explored: belief updating, which computes the posterior probability of the network variables in the presence of evidence; and abductive reasoning, which identifies the most probable instantiation of network variables given some evidence. Many diagnostic, prognostic, and therapeutic questions can be represented in terms of these query Types. For models that are complex, exact inference techniques are computationally intractable; instead, approximate inference methods can be leveraged. We also briefly cover special classes of belief networks that are relevant in medicine: probabilistic relational models, which provide a compact representation of large number of propositional variables through the use of first-order logic; influence diagrams, which provide a means of selecting optimal plans given cost/preference constraints; and naïve Bayes classifiers. Importantly, the question of how to validate the accuracy of belief networks is explored through cross validation and sensitivity analysis. Finally, we explore how the intrinsic properties of a graphical model (e.g., variable selection, structure, parameters) can assist users with interacting with and understanding the results of a model through feedback. Applications of Bayesian belief networks in image processing, querying, and case-based retrieval from large imaging repositories are demonstrated.