Skip to main content
Erschienen in: Journal of Medical Systems 3/2012

01.06.2012 | ORIGINAL PAPER

Fuzzy Rule-Based Expert System for Assessment Severity of Asthma

verfasst von: Maryam Zolnoori, Mohammad Hossein Fazel Zarandi, Mostafa Moin, Shahram Teimorian

Erschienen in: Journal of Medical Systems | Ausgabe 3/2012

Einloggen, um Zugang zu erhalten

Abstract

Prescription medicine for asthma at primary stages is based on asthma severity level. Despite major progress in discovering various variables affecting asthma severity levels, disregarding some of these variables by physicians, variables’ inherent uncertainty, and assigning patients to limited categories of decision making are the major causes of underestimating asthma severity, and as a result low quality of life in asthmatic patients. In this paper, we provide a solution of intelligence fuzzy system for this problem. Inputs of this system are organized in five modules of respiratory symptoms, bronchial obstruction, asthma instability, quality of life, and asthma severity. Output of this system is degree of asthma severity in score (0–10). Evaluating performance of this system by 28 asthmatic patients reinforces that the system’s results not only correspond with evaluations of physicians, but represent the slight differences of asthmatic patients placed in specific category introduced by guidelines.
Anhänge
Nur mit Berechtigung zugänglich
Literatur
1.
Zurück zum Zitat Hanania, A. N., Revisiting asthma control: How should it best be defined? Pulm. Pharmacol. Ther. 20(5):483–492, 2007.CrossRef Hanania, A. N., Revisiting asthma control: How should it best be defined? Pulm. Pharmacol. Ther. 20(5):483–492, 2007.CrossRef
3.
Zurück zum Zitat Bavgek, S., Mungan, D., Türktaş, H., Mısırlıgil, Z., and Gemicioğlu, B., A cost-of-illness study estimating the direct cost per asthma exacerbation in Turkey, Respiratory Medicine, 2010. Bavgek, S., Mungan, D., Türktaş, H., Mısırlıgil, Z., and Gemicioğlu, B., A cost-of-illness study estimating the direct cost per asthma exacerbation in Turkey, Respiratory Medicine, 2010.
4.
Zurück zum Zitat Yan, D. C., Ou, L. S., Tsai, T. L., Wu, W. F., and Huang, J. L., Prevalence and severity of symptoms of asthma, rhinitis, and eczema in 13- to 14-year-old children in Taipei, Taiwan. Ann. Allergy Asthma Immunol. 95(6):579–585, 2005.CrossRef Yan, D. C., Ou, L. S., Tsai, T. L., Wu, W. F., and Huang, J. L., Prevalence and severity of symptoms of asthma, rhinitis, and eczema in 13- to 14-year-old children in Taipei, Taiwan. Ann. Allergy Asthma Immunol. 95(6):579–585, 2005.CrossRef
5.
Zurück zum Zitat Wolfenden, L. L., Diette, G. B., Krishnan, J. A., Skinner, E. A., Steinwachs, D. M., and Wu, A. W., Lower physician estimate of underlying asthma severity leads to undertreatment. Arch. Intern. Med. 163:231–236, 2003.CrossRef Wolfenden, L. L., Diette, G. B., Krishnan, J. A., Skinner, E. A., Steinwachs, D. M., and Wu, A. W., Lower physician estimate of underlying asthma severity leads to undertreatment. Arch. Intern. Med. 163:231–236, 2003.CrossRef
6.
Zurück zum Zitat Rodrigo, G. J., Plaza, V., Neffen, H., Levy, G., and Perpina, M., Relationship between the characteristic of hospitalized acute asthma patients and the severity of their asthma. A case control study. J. Allergol. Immunopathol. 37(5):225–229, 2009.CrossRef Rodrigo, G. J., Plaza, V., Neffen, H., Levy, G., and Perpina, M., Relationship between the characteristic of hospitalized acute asthma patients and the severity of their asthma. A case control study. J. Allergol. Immunopathol. 37(5):225–229, 2009.CrossRef
7.
Zurück zum Zitat Gautier, V., Redier, H., Pujol, J. L., Bousquet, J., Proundhon, H., Michel, C., Daures, J. P., Michel, F. B., and Godard, Ph, Comparison of an expert system with other clinical scores for the evaluation of the severity of asthma. Eur. Respir. J. 9:58–54, 1996.CrossRef Gautier, V., Redier, H., Pujol, J. L., Bousquet, J., Proundhon, H., Michel, C., Daures, J. P., Michel, F. B., and Godard, Ph, Comparison of an expert system with other clinical scores for the evaluation of the severity of asthma. Eur. Respir. J. 9:58–54, 1996.CrossRef
8.
Zurück zum Zitat Global Initiative for Asthma. Global Strategy for Management and Prevention. National Heart, Lung, and Blood Institute. National Institutes of Health. 2009 NIH publication (online). WWW URL. Http:\\www.ginasthma.com. Accessed December 2009. Global Initiative for Asthma. Global Strategy for Management and Prevention. National Heart, Lung, and Blood Institute. National Institutes of Health. 2009 NIH publication (online). WWW URL. Http:​\\www.​ginasthma.​com. Accessed December 2009.
9.
Zurück zum Zitat Üncü, Ü., Evaluation of pulmonary function tests by using fuzzy logic theory. J. Med. Syst. 34(2):223–417, 2009. Üncü, Ü., Evaluation of pulmonary function tests by using fuzzy logic theory. J. Med. Syst. 34(2):223–417, 2009.
10.
Zurück zum Zitat Aas, K., Heterogeneity of bronchial asthma. Allergy. 36:3–14, 1981.CrossRef Aas, K., Heterogeneity of bronchial asthma. Allergy. 36:3–14, 1981.CrossRef
11.
Zurück zum Zitat Hargreave, F. E., Dolovich, J., and Newhouse, M. T., The assessment and treatment of asthma: A conference report. J. Allergy Clin. Immunol. 85:1098–1111, 1990.CrossRef Hargreave, F. E., Dolovich, J., and Newhouse, M. T., The assessment and treatment of asthma: A conference report. J. Allergy Clin. Immunol. 85:1098–1111, 1990.CrossRef
12.
Zurück zum Zitat Brooks, S. M., Bernstein, L., Raghuprasad, P. K., Maccia, C. A., and Mieczkowski, L., Assessment of airway hyperresponsiveness in chronic stable asthma. J. Allergy Clin. Immunol. 85:17–26, 1990.CrossRef Brooks, S. M., Bernstein, L., Raghuprasad, P. K., Maccia, C. A., and Mieczkowski, L., Assessment of airway hyperresponsiveness in chronic stable asthma. J. Allergy Clin. Immunol. 85:17–26, 1990.CrossRef
13.
Zurück zum Zitat Global Initiative for Asthma. Global Strategy for Management and Prevention 2006 Revision. National Institutes of Health, National Heart,Lung, and Blood Institute (online). WWW URL: http//www.ginasthma.com. Accessed august 2006. Global Initiative for Asthma. Global Strategy for Management and Prevention 2006 Revision. National Institutes of Health, National Heart,Lung, and Blood Institute (online). WWW URL: http/​/​www.​ginasthma.​com. Accessed august 2006.
14.
Zurück zum Zitat Boulet, L. P., Becker, A., Berube, D., et al., Canadian Asthma Consensus Report, 1999. Canadian Asthma Consensus Group. CMAJ. 161(Suppl. 11):S1–S61, 1999. Boulet, L. P., Becker, A., Berube, D., et al., Canadian Asthma Consensus Report, 1999. Canadian Asthma Consensus Group. CMAJ. 161(Suppl. 11):S1–S61, 1999.
15.
Zurück zum Zitat Combescure, C., Chanez, P., Saint-Pierre, P., Daure’s, J.-P., Proudhon, H., and Godard, P., Assessment of variations in control of asthma over time. Eur. Respir. J. 22:298–304, 2003.CrossRef Combescure, C., Chanez, P., Saint-Pierre, P., Daure’s, J.-P., Proudhon, H., and Godard, P., Assessment of variations in control of asthma over time. Eur. Respir. J. 22:298–304, 2003.CrossRef
16.
Zurück zum Zitat Shout, J. W., Visness, M. C., Enright, P., Lamm, C., Shapiro, G., Gan, N. V., Adams, G. K., and Mitchell, H. E., Classification of asthma severity in children the contribution of pulmonary function testing. Arch. Pediatr. Adolesc. Med. 160:844–850, 2006.CrossRef Shout, J. W., Visness, M. C., Enright, P., Lamm, C., Shapiro, G., Gan, N. V., Adams, G. K., and Mitchell, H. E., Classification of asthma severity in children the contribution of pulmonary function testing. Arch. Pediatr. Adolesc. Med. 160:844–850, 2006.CrossRef
17.
Zurück zum Zitat Yen, C. Y., Rule selection in fuzzy expert system. Expert Syst. Appl. 16:79–84, 1999.CrossRef Yen, C. Y., Rule selection in fuzzy expert system. Expert Syst. Appl. 16:79–84, 1999.CrossRef
19.
Zurück zum Zitat Global Initiative for Asthma, Global Strategy for Management and Prevention, National Institutes of Health, National Heart, Lung, and Blood Institute, 2008 NIH publication. Global Initiative for Asthma, Global Strategy for Management and Prevention, National Institutes of Health, National Heart, Lung, and Blood Institute, 2008 NIH publication.
20.
Zurück zum Zitat Kornelija, K., Slavica, D., Dorijan, T. D., and Miljenko, R., Correlation between asthma severity and serum IgE in asthmatic children sensitized to Dermatophagoides pteronyssinus. Arch. Med. Res. 38(no 1):99–105, 2007.CrossRef Kornelija, K., Slavica, D., Dorijan, T. D., and Miljenko, R., Correlation between asthma severity and serum IgE in asthmatic children sensitized to Dermatophagoides pteronyssinus. Arch. Med. Res. 38(no 1):99–105, 2007.CrossRef
21.
Zurück zum Zitat Mamdani, E. H., and Assilian, S., An expriment in linguistic synthesis with a fuzzy logic controller. Int. Man Mach. Stud. 7:1–13, 1975.MATHCrossRef Mamdani, E. H., and Assilian, S., An expriment in linguistic synthesis with a fuzzy logic controller. Int. Man Mach. Stud. 7:1–13, 1975.MATHCrossRef
22.
Zurück zum Zitat Emami, R. M., Turksen, I. B., and Goldenberg, A. A., A unified parameterized formulation of reasoning in fuzzy modeling and control. Fuzzy Sets Syst. 108:59–81, 1999.MathSciNetMATHCrossRef Emami, R. M., Turksen, I. B., and Goldenberg, A. A., A unified parameterized formulation of reasoning in fuzzy modeling and control. Fuzzy Sets Syst. 108:59–81, 1999.MathSciNetMATHCrossRef
23.
Zurück zum Zitat Morgan, W. J., Crain, E. F., Gruchalla, R. S., et al., Results of a home-based environmental intervention among urban children with asthma. N. Engl. J. Med. 351:1068–1080, 2004.CrossRef Morgan, W. J., Crain, E. F., Gruchalla, R. S., et al., Results of a home-based environmental intervention among urban children with asthma. N. Engl. J. Med. 351:1068–1080, 2004.CrossRef
24.
Zurück zum Zitat Rubinfeld, A. R., and Pain, M. C. F., Relationship between bronchial reactivity, airway caliber and severity of asthma. Am. Rev. Respir. Dis. 115:381–387, 1977. Rubinfeld, A. R., and Pain, M. C. F., Relationship between bronchial reactivity, airway caliber and severity of asthma. Am. Rev. Respir. Dis. 115:381–387, 1977.
25.
Zurück zum Zitat Stout, J. W., Visness, C. M., Enright, P., Lamm, C., Shapiro, G., Gan, V. N., Adams, G. K., and Mitchell, H. E., Classification of asthma severity in children, the contribution of pulmonary function testing. Arch. Pediatric. Adolesc. Med. 160(8):844–850, 2006.CrossRef Stout, J. W., Visness, C. M., Enright, P., Lamm, C., Shapiro, G., Gan, V. N., Adams, G. K., and Mitchell, H. E., Classification of asthma severity in children, the contribution of pulmonary function testing. Arch. Pediatric. Adolesc. Med. 160(8):844–850, 2006.CrossRef
26.
Zurück zum Zitat Enright, P. L., lebowitz, M. D., and Cockroft, D. W., Physiologic measures: Pulmonary function tests: Asthma outcome. Am. J. Respir. Crit. Care Med. 149:S9–S18, 1994. Enright, P. L., lebowitz, M. D., and Cockroft, D. W., Physiologic measures: Pulmonary function tests: Asthma outcome. Am. J. Respir. Crit. Care Med. 149:S9–S18, 1994.
27.
Zurück zum Zitat Bacharier, B. L., Strunk, C. R., Mauger, D., White, D., Lemanske, F. R., and Sorkness, A. C., Classifying asthma severity in children mismatch between symptoms, medication use, and lung function. Am. J. Respir. Crit. Care Med. 170:426–432, 2004.CrossRef Bacharier, B. L., Strunk, C. R., Mauger, D., White, D., Lemanske, F. R., and Sorkness, A. C., Classifying asthma severity in children mismatch between symptoms, medication use, and lung function. Am. J. Respir. Crit. Care Med. 170:426–432, 2004.CrossRef
28.
Zurück zum Zitat Lil, J. T., Schatz, M., Sorkness, C. A., Murray, J. J., Marcus, P., Nathan, R. A., Pendergraft, T. B., Kosinski, M., and Stanford, R. H., Specialist asthma care results in superior assessment of asthma control. J. Allergy Clin. Immunol. 113(2):S253, 2004. Lil, J. T., Schatz, M., Sorkness, C. A., Murray, J. J., Marcus, P., Nathan, R. A., Pendergraft, T. B., Kosinski, M., and Stanford, R. H., Specialist asthma care results in superior assessment of asthma control. J. Allergy Clin. Immunol. 113(2):S253, 2004.
29.
Zurück zum Zitat Eigen, H., Pulmonary function testing. In: Murphy, S., and Kelly, H. W. (Eds.), Pediatric Asthma. Marcel Eekker, Inc, New York, pp. 131–150, 1999. Eigen, H., Pulmonary function testing. In: Murphy, S., and Kelly, H. W. (Eds.), Pediatric Asthma. Marcel Eekker, Inc, New York, pp. 131–150, 1999.
30.
Zurück zum Zitat Wright, A., Holberg, C., Morgan, W., Taussig, L., Halonen, M., and Martinez, F., Recurrent cough in childhood and its relation to asthma. Am. J. Respir. Crit. Care Med. 153:1259–1265, 1996. Wright, A., Holberg, C., Morgan, W., Taussig, L., Halonen, M., and Martinez, F., Recurrent cough in childhood and its relation to asthma. Am. J. Respir. Crit. Care Med. 153:1259–1265, 1996.
31.
Zurück zum Zitat Devulapalli, C. S., Carlsen, K. C., Håland, G., Munthe-Kaas, M. C., Pettersen, M., Mowinckel, P., and Carlsen, K. H., Severity of obstructive airways disease by age 2 years predicts asthma at 10 years of age. Thorax. 63(1):8–13, 2008.CrossRef Devulapalli, C. S., Carlsen, K. C., Håland, G., Munthe-Kaas, M. C., Pettersen, M., Mowinckel, P., and Carlsen, K. H., Severity of obstructive airways disease by age 2 years predicts asthma at 10 years of age. Thorax. 63(1):8–13, 2008.CrossRef
32.
Zurück zum Zitat Everhar R. S., and Fiese, B., Asthma severity and child quality of life in pediatric asthma: A systematic review. Patient Educ Couns. 75(2):162–168, 2009. Everhar R. S., and Fiese, B., Asthma severity and child quality of life in pediatric asthma: A systematic review. Patient Educ Couns. 75(2):162–168, 2009.
33.
Zurück zum Zitat Redier, H., Daures, J.-P., Michel, C., Proudhon, H., Vervloet, D., Charpin, D., Marsac, J., Dusser, D., Brambilla, C., Wallaert, B., Kopferschmitt, M.-C., Pauli, G., Taytard, A., Cogis, O., Cogis, O., Michel, F.-B., and Godard, P., Assessment of the severity of asthma by an expert system: Description and evaluation. Am. J. Respir. Crit. Care Med. 151(21):345–352, 1995. Redier, H., Daures, J.-P., Michel, C., Proudhon, H., Vervloet, D., Charpin, D., Marsac, J., Dusser, D., Brambilla, C., Wallaert, B., Kopferschmitt, M.-C., Pauli, G., Taytard, A., Cogis, O., Cogis, O., Michel, F.-B., and Godard, P., Assessment of the severity of asthma by an expert system: Description and evaluation. Am. J. Respir. Crit. Care Med. 151(21):345–352, 1995.
34.
Zurück zum Zitat Moin, M., Principle of asthma. In: Moine, M., et al. (Eds.), Asthma; Basic clinical science, 1st edition. University Publication Center, Tehran, 2003. Moin, M., Principle of asthma. In: Moine, M., et al. (Eds.), Asthma; Basic clinical science, 1st edition. University Publication Center, Tehran, 2003.
36.
Zurück zum Zitat Phuong, H. N., and Kreinovich, V., Fuzzy logic and its applications in medicine. Int. J. Med. Inform. 62:165–173, 2001.CrossRef Phuong, H. N., and Kreinovich, V., Fuzzy logic and its applications in medicine. Int. J. Med. Inform. 62:165–173, 2001.CrossRef
37.
Zurück zum Zitat Sugeno, M., and Yasukawa, T., A fuzzy-logic-based approach to qualitative modeling. IEEE Trans. Fuzzy Syst. 1(1):7–30, 1993.CrossRef Sugeno, M., and Yasukawa, T., A fuzzy-logic-based approach to qualitative modeling. IEEE Trans. Fuzzy Syst. 1(1):7–30, 1993.CrossRef
38.
Zurück zum Zitat Schwartz, G., Gupta, R. S., Springston, E., Zhang, X., and Grammer, L. C., The association between crime and adult asthma severity. J. Allergy Clin. Immunol. 125(2):AB32, 2010. Schwartz, G., Gupta, R. S., Springston, E., Zhang, X., and Grammer, L. C., The association between crime and adult asthma severity. J. Allergy Clin. Immunol. 125(2):AB32, 2010.
39.
Zurück zum Zitat Everhart, R. S., Barbara, H. F., Asthma severity and child quality of life in pediatric asthma: A systematic review. Patient Educ Couns. 75(2):162–168, 2009. Everhart, R. S., Barbara, H. F., Asthma severity and child quality of life in pediatric asthma: A systematic review. Patient Educ Couns. 75(2):162–168, 2009.
40.
Zurück zum Zitat Lurie, A., Marsala, C., Hartley, S., Bouchon-Meunier, B., and Dusser, D., Patients’ perception of asthma severity. Respir. Med. 101:2145–2152, 2007.CrossRef Lurie, A., Marsala, C., Hartley, S., Bouchon-Meunier, B., and Dusser, D., Patients’ perception of asthma severity. Respir. Med. 101:2145–2152, 2007.CrossRef
41.
Zurück zum Zitat Robin, S., Everhart, R., and Fiese, B., Asthma severity and child quality of life in pediatric asthma: A systematic review, Patient Education and Counseling, PEC-3232, 2008. Robin, S., Everhart, R., and Fiese, B., Asthma severity and child quality of life in pediatric asthma: A systematic review, Patient Education and Counseling, PEC-3232, 2008.
42.
Zurück zum Zitat Joseph, C., Baptist, A., Stringer, S., Havstad, S., Ownby, D., Johnson, C., Williams, L., and Peterson, E., Identifying students with self-report of asthma and respiratory symptoms in an urban, High school setting. J. Urban Health. 84(1):60–69, 2007.CrossRef Joseph, C., Baptist, A., Stringer, S., Havstad, S., Ownby, D., Johnson, C., Williams, L., and Peterson, E., Identifying students with self-report of asthma and respiratory symptoms in an urban, High school setting. J. Urban Health. 84(1):60–69, 2007.CrossRef
43.
Zurück zum Zitat Bateman, D., Hurd, S., Barnes, J., Bousquet, J., Drazen, J., itzGerald, F., Gibson, M., Gibson, F., Ohta, K., O’Byrne, P., Pedersen, S., Pizzichini, E., Sullivan, S., and Zar, H., Global strategy for asthma management and prevention: GINA executive summary. Eur. Respir. J. 31:143–178, 2008.CrossRef Bateman, D., Hurd, S., Barnes, J., Bousquet, J., Drazen, J., itzGerald, F., Gibson, M., Gibson, F., Ohta, K., O’Byrne, P., Pedersen, S., Pizzichini, E., Sullivan, S., and Zar, H., Global strategy for asthma management and prevention: GINA executive summary. Eur. Respir. J. 31:143–178, 2008.CrossRef
44.
Zurück zum Zitat Pedersen, S., Pauwels, R. A., Tan, W. C., Chen, Y. Z., Lamm, C. J., and O’Byrne, P. M., effectiveness of early intervention with budesonide in mild persistent asthma. J. Allergy Clin. Immunol. 121(5):1167–1174, 2008.CrossRef Pedersen, S., Pauwels, R. A., Tan, W. C., Chen, Y. Z., Lamm, C. J., and O’Byrne, P. M., effectiveness of early intervention with budesonide in mild persistent asthma. J. Allergy Clin. Immunol. 121(5):1167–1174, 2008.CrossRef
45.
Zurück zum Zitat Kelly, L., Ronmark, E., Roper, J., James, H., Lundback, B., and Platts-Mills, T., IgE And IgG antibodies to cat allergens in relation to asthma severity among 963 teenagers living in Northern Sweden. J. Allergy Clin. Immunol. 125(2):AB188, 2010. Kelly, L., Ronmark, E., Roper, J., James, H., Lundback, B., and Platts-Mills, T., IgE And IgG antibodies to cat allergens in relation to asthma severity among 963 teenagers living in Northern Sweden. J. Allergy Clin. Immunol. 125(2):AB188, 2010.
46.
Zurück zum Zitat Brightling, C. E., Burney, P., et al., Uniform definition of asthma severity, control, and exacerbations: Document presented for the World Health Organization Consultation on Severe Asthma. J. Allergy Clin. Immunol. 126(5):926–938, 2010.CrossRef Brightling, C. E., Burney, P., et al., Uniform definition of asthma severity, control, and exacerbations: Document presented for the World Health Organization Consultation on Severe Asthma. J. Allergy Clin. Immunol. 126(5):926–938, 2010.CrossRef
47.
Zurück zum Zitat Omachi, T. A., Poor outcomes and asthma hospitalisations: How important is asthma severity and how do we measure it? Allergol Immunopathol (Madr). 37(5):223–224, 2009. Omachi, T. A., Poor outcomes and asthma hospitalisations: How important is asthma severity and how do we measure it? Allergol Immunopathol (Madr). 37(5):223–224, 2009.
48.
Zurück zum Zitat Madhok, N., Kipperman, S., Tom, C., Sin, S., and Rastogi, D., “Parental perception and knowledge of asthma severity and management of athmatic children in the bronx”. J. Allergy Clin. Immunol. 123(2):S161, 2009. Madhok, N., Kipperman, S., Tom, C., Sin, S., and Rastogi, D., “Parental perception and knowledge of asthma severity and management of athmatic children in the bronx”. J. Allergy Clin. Immunol. 123(2):S161, 2009.
49.
Zurück zum Zitat Janssens, T., verleden, G., Peuter, S. D., Diest, I. V., and Bergh, O. V. D., Inaccurate perception of asthma symptoms: A cognitive–affective framework and implications for asthma treatment. Clin Psychol Rev. 29(4):317–327, 2009. Janssens, T., verleden, G., Peuter, S. D., Diest, I. V., and Bergh, O. V. D., Inaccurate perception of asthma symptoms: A cognitive–affective framework and implications for asthma treatment. Clin Psychol Rev. 29(4):317–327, 2009.
Metadaten
Titel
Fuzzy Rule-Based Expert System for Assessment Severity of Asthma
verfasst von
Maryam Zolnoori
Mohammad Hossein Fazel Zarandi
Mostafa Moin
Shahram Teimorian
Publikationsdatum
01.06.2012
Verlag
Springer US
Erschienen in
Journal of Medical Systems / Ausgabe 3/2012
Print ISSN: 0148-5598
Elektronische ISSN: 1573-689X
DOI
https://doi.org/10.1007/s10916-010-9631-8

Weitere Artikel der Ausgabe 3/2012

Journal of Medical Systems 3/2012 Zur Ausgabe