Elicitating Patient Patterns of Physician Non-Compliance with Breast Cancer Guidelines Using Formal Concept Analysis

Jacques Bouaud (1, 2) , Nizar Messai (3) , Cédric Laouénan (4) , France Mentre , Brigitte Séroussi (5, 6)

1 LIMICS - Laboratoire d'Informatique Médicale et Ingénierie des Connaissances en e-Santé
2 AP-HP - Assistance publique - Hôpitaux de Paris (AP-HP)
3 LIFAT - Laboratoire d'Informatique Fondamentale et Appliquée de Tours
4 Département d'épidémiologie, biostatistique et recherche clinique
5 SPIM - Laboratoire de Santé Publique et Informatique Médicale
6 STIM/AP-HP

Because they provide patient-specific guideline-based recommendations, clinical decision support systems (CDSSs) are expected to promote the implementation of clinical practice guidelines (CPGs). OncoDoc2 is a CDSS applied to the management of breast cancer. However, despite it was routinely used during weekly multidisciplinary staff meetings (MSMs) at the Tenon Hospital (Paris, France), the compliance rate of MSMs' decisions with CPGs did not reach 100%. Formal Concept Analysis (FCA) has been applied to elicit formal concepts related to non-compliance. A statistical pre-treatment of attributes has been proposed to leverage FCA and discriminate between compliant and non-compliant decisions. Among the 1,889 decisions made over a 3 year-period, 199 decisions of recommended re-excisions have been considered for analysis. In this sample, non-compliance was explained by uncommon clinical profiles and specific patient-centred clinical criteria.

Domaines: Base de données [cs.DB]

Jacques Bouaud, Nizar Messai, Cédric Laouénan, France Mentre, Brigitte Séroussi. Elicitating Patient Patterns of Physician Non-Compliance with Breast Cancer Guidelines Using Formal Concept Analysis. 24th European Medical Informatics Conference, 2012, Piza, Italy. pp.477-481. ⟨hal-01024391⟩