ArgMed: A Support System for Medical Decision Making Based on the Analysis of Clinical Discussions

This paper presents the design, development and experimentation of ArgMed, an interactive system aimed at supporting decision making processes that occur during clinical discussions. Clinical discussions take place on a regular basis in hospital wards and provide the forum for specialists of various medical disciplines to focus on critical cases, debate about diagnostic hypotheses, therapeutic protocols or follow-up of patient conditions, and to devise the most appropriate treatments. However, in the current medical practice, clinical discussions are usually not documented, and only the final decision is recorded on patient medical records. Therefore, some decision alternatives may get lost, the justifications for decisions made are not clarified, and the reasons in favor or against a diagnosis or a treatment remain implicit. ArgMed addresses these issues by supporting (1) the representation of discussions in a structured yet intuitive way, (2) the formalization of discussions from a logical perspective on the basis of a set of reasoning patterns (argumentation schemes) that are considered valid in the specific medical domain, (3) the identification of plausible conclusions, as well as invalid reasoning steps, hidden assumptions, or missing evidences. The paper describes the approach adopted for ArgMed design, the system architecture and operation, and the knowledge-based engine that implements decision support. The results of a preliminary experimentation of ArgMed in a real clinical environment are finally discussed.