Bayesian networks for clinical decision support in lung cancer care

PLoS One. 2013 Dec 6;8(12):e82349. doi: 10.1371/journal.pone.0082349. eCollection 2013.

Abstract

Survival prediction and treatment selection in lung cancer care are characterised by high levels of uncertainty. Bayesian Networks (BNs), which naturally reason with uncertain domain knowledge, can be applied to aid lung cancer experts by providing personalised survival estimates and treatment selection recommendations. Based on the English Lung Cancer Database (LUCADA), we evaluate the feasibility of BNs for these two tasks, while comparing the performances of various causal discovery approaches to uncover the most feasible network structure from expert knowledge and data. We show first that the BN structure elicited from clinicians achieves a disappointing area under the ROC curve of 0.75 (± 0.03), whereas a structure learned by the CAMML hybrid causal discovery algorithm, which adheres with the temporal restrictions, achieves 0.81 (± 0.03). Second, our causal intervention results reveal that BN treatment recommendations, based on prescribing the treatment plan that maximises survival, can only predict the recorded treatment plan 29% of the time. However, this percentage rises to 76% when partial matches are included.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Algorithms
  • Area Under Curve
  • Artificial Intelligence
  • Bayes Theorem*
  • Cluster Analysis
  • Databases, Factual
  • Decision Support Techniques*
  • Delivery of Health Care*
  • Humans
  • Lung Neoplasms* / mortality
  • Lung Neoplasms* / pathology
  • Lung Neoplasms* / therapy
  • Neoplasm Staging
  • Prognosis
  • Reproducibility of Results

Grants and funding

This research has been funded by the Clarendon and the New College Graduate Scholarships through the CDT in Healthcare Innovation Programme at the Biomedical Engineering Institute of the University Of Oxford. MB acknowledges support from the Cancer Research United Kingdom/Engineering and Physical Sciences Research Council Oxford Cancer Imaging Centre. AN acknowledges funding from FEDER funds and the Spanish Government (Ministerio de Ciencia e Innovación) through project TIN2010-20900-C04-03. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.