Bayesian Networks for Clinical Decision Support in Lung Cancer Care.docVIP

Bayesian Networks for Clinical Decision Support in Lung Cancer Care M. Berkan Sesen , Ann E. Nicholson , Rene Banares-Alcantara , Timor Kadir , Michael Brady 1* 2 1 3 4 1 Department of Engineering Science, University of Oxford, Oxford, United Kingdom, 2 Faculty of Information Technology, Monash University, Clayton, Victoria, Australia, 3 Mirada Medical, Oxford, United Kingdom, 4 Department of Oncology, University of Oxford, Oxford, United Kingdom 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. Citation: Sesen MB, Nicholson AE, Banares-Alcantara R, Kadir T, Brady M (2013) Bayesian Networks for Clinical Decision Support in Lung Cancer Care. PLoS ON