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SLEEP-EVAL© RESEARCHSleep Epidemiology Research & Sleep-EVALTM Diagnosis Expert System |
Stanford Sleep Epidemiology Journal Stanford Sleep Epidemiology Research Center (SSERC) Psy-EVAL Research
"Not
everything that can be counted counts,
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Last edited |
12/11/2011Written by Maurice M. Ohayon, MD, DSc, PhD
When the first epidemiological survey was launched in 1992, we were looking for an assessment tool that could be used by interviewers with little knowledge about sleep disorders.
We also wanted a tool that allowed the broad coverage of sleep habits, including sleep/wake schedule and sleep hygiene.
The tool also had to permit the identification of mental disorders most frequently associated with sleep problems; and, most of all, the tool should allow the formulation of sleep diagnoses according to several classifications.
Tools that met all these requirements were nonexistent.
Questionnaires to assess sleep disorders covered only some disorders.
None of them was designed to allow a differential diagnosis making.
Briefly:
- in 1983,
creation of Adinfer (©M Ohayon, 1983) a level 0+ expert system
devoted to the assessment of psychiatric disorders.
- from 1983 to 1991, Adinfer went through several changes to increase its
diagnostic abilities.
- in 1990,
creation of Sleep-EVAL (©M Ohayon, 1990), a
level-2 expert system endowed with a causal reasoning mode.
The integration of a neural network in an expert system gives “reasoning” aibilities that are the closest to human reasoning at this time.
Indeed, neural networks are able to find solutions to problems that usually require human observations or thought processes.
When used in diagnostic processes, they allow incorporation of subjectivity in answers provided by the subject and manage the resulting uncertainty in the assessment of a disorder.
Sleep-EVAL was developed with clear objectives in mind:
to improve the quality of collected data,
to find new ways to analyze risk factors associated with some abnormalities, and finally,
to provide some kind of validation of the usefulness of existing classifications such as the DSM-IV (APA, 1994), the International Classification of Sleep Disorders (ASDA, 1990, 1997), and the International Classification of Disease (ICD-10, WHO).
The use of fuzzy logic reasoning managed by a neural network was allowing the inclusion of the richness of clinical experience in a tool that can be used by inexperienced interviewers.
When the first epidemiological survey was launched in 1992, we were looking for an assessment tool that could be used by interviewers with little knowledge about sleep disorders.
The Sleep-EVAL Expert System
Sleep-EVAL, an artificial intelligent
computer program, is an Expert System for evaluation and diagnosis of Sleep and
Mental Disorders in general and clinical populations
Knowledge Base
The inference engine uses its knowledge base to pose questions, to
infer
hypotheses and to deduce diagnostic conclusions
Inference Engine
Sleep-EVAL is a non-monotonic, level-2
expert system endowed with the ability to make logical connections based on
patient information (causal reasoning mode).
Fuzzy Logic
Inference models such as probabilistic
and fuzzy systems can be used to integrate uncertainty in both symptomatic
assessment and diagnostic attribution.
It therefore becomes possible to extend
boundaries and attribute a degree of certainty to a diagnosis.
A probabilistic model can be easily
computed from an existent binary data set.
A fuzzy model can also be calculated from an existent data set, but
the model is obviously much more precise when the data are
expressed in categorical terms.