Using Decision Trees as an Expert System for Clinical Decision Support for COVID-19

Interact J Med Res. 2023 Jan 30:12:e42540. doi: 10.2196/42540.

Abstract

COVID-19 has impacted billions of people and health care systems globally. However, there is currently no publicly available chatbot for patients and care providers to determine the potential severity of a COVID-19 infection or the possible biological system responses and comorbidities that can contribute to the development of severe cases of COVID-19. This preliminary investigation assesses this lack of a COVID-19 case-by-case chatbot into consideration when building a decision tree with binary classification that was stratified by age and body system, viral infection, comorbidities, and any manifestations. After reviewing the relevant literature, a decision tree was constructed using a suite of tools to build a stratified framework for a chatbot application and interaction with users. A total of 212 nodes were established that were stratified from lung to heart conditions along body systems, medical conditions, comorbidities, and relevant manifestations described in the literature. This resulted in a possible 63,360 scenarios, offering a method toward understanding the data needed to validate the decision tree and highlighting the complicated nature of severe cases of COVID-19. The decision tree confirms that stratification of the viral infection with the body system while incorporating comorbidities and manifestations strengthens the framework. Despite limitations of a viable clinical decision tree for COVID-19 cases, this prototype application provides insight into the type of data required for effective decision support.

Keywords: COVID-19; assessment tool; chatbot; clinical decision support; decision tree; digital health tool; framework; health informatics; health intervention; prototype.