A multi-modal reasoning methodology for managing IDDM patients

We present a knowledge management and decision support methodology for insu lin dependent diabetes mellitus (IDDM) patients care. Such methodology expl oits the integration of case based reasoning (CBR) and rule based reasoning (RBR), with the aim of helping physicians during therapy planning, by over coming the intrinsic limitations shown by the independent application of th e two reasoning paradigms. RBR provides suggestions on the basis of a situa tion detection mechanism that relies on formalized prior knowledge; CBR is used to specialize and dynamically adapt the rules on the basis of the pati ent's characteristics and of the accumulated experience. When the case libr ary is not representative of the overall population, only RBR is applied to define a therapy for the input situation, which can then be retained, enri ching the case library competence. The paper reports the first evaluation r esults, obtained both on simulated examples and on real patients. This work was developed within the EU funded telematic management of insulin depende nt diabetes mellitus (T-IDDM) project, and is fully integrated in its web-b ased architecture. (C) 2000 Elsevier Science Ireland Ltd. All rights reserv ed.