gms | German Medical Science

Background: We have a vision of CESDiT, a large C̲ase-based precision medicine E̲xpert S̲ystem(ES) for D̲i̲agnostics and T̲herapy. An envisioned example use of CESDiT is that a general practice patient describes symptoms of a urinary tract infection(UTI) to CESDiT in a dialogue, CESDiT suggests a dipstick test, patient enters the results, CESDiT questions further to personalise the predictions, CESDiT compares personalised predictions of UTI symptom durations and adverse event risks of antibiotic and alternative therapies.

Research question: What small, but usable ES could be the prototype of CESDiT? Predicting which outcome will be most helpful? How to feasibly realise the ES using a small budget?

Methods: (1) We drafted the development roadmap of CESDiT, (2) enumerated our resources, (3) defined the prototype and project outcomes conforming to the roadmap, (4) planned the development, (5) estimated the risks and resource requirements.

Results: We compiled the project-plan of the prototype:

1.

Draft development plan of CESDiT.

2.

Our group has UTI research expertise in general practice with some data available from clinical trials.

3.

Outcomes: (A) Prototype using one trial dataset, performing the core functions: The prototype asks about symptoms and predictors, user selects options, the prototype compares predicted personalised symptom durations of two UTI treatments. (B) Plan of the next development stage. (C) Data use agreements with international collaborators for the next development stage of CESDiT.

4.

Development plan: (A) We model treatment outcomes using Bayesian statistical prediction allowing for unanswered questions; program a user interface that checks eligibility, questions about predictors, formats the predictions. Other project steps are (B) international networking, agreeing on data sharing; and (C) planning the development of the next project stage considering the lessons learnt.

5.

This plan is low risk and feasible.

Discussion: The above plan develops a prototype precision medicine expert system used by patients with UTI (or their doctors) and provides personalised, educational output. The prototype and the international collaborations pave the road towards CESDiT.