Technology to support medical decision making

A project based in Oxford uses artificial intelligence to help hard-pressed clinicians decide how to treat their patients.

The modern clinical environment is complex: with a wealth of established knowledge and new research published every week, doctors have their work cut out if they’re to make the right decision every time. Researchers based in Oxford think they can help by offering technology that can suggest options for a wide range of medical decisions.

The Cognitive Science and Systems group (COSSAC), split between the University of Oxford and London’s Royal Free Hospital, is a small team with big ideas. They aim to understand the complexities of high level cognition, but also build software systems that use this understanding to support clinical decision-making and patient care.

The team’s flagship project is CREDO, which uses software technology that applies medical reasoning to assess patients’ circumstances and recommend appropriate care. Clinicians add data to a patient profile, from test results to images and current treatment regimes. The software then analyses the current situation against clinical guidelines to suggest the most suitable course of action.

Importantly, the systems are safe and ethical: clinicians can act on or reject the suggestions as they see fit and recommendations are accompanied by patient-specific explanations in an easily understandable format. Patients also benefit: they can use the web or their mobile phone to report any concerns, triggering personalised changes to their care.

The Royal Free Hospital in London is using this technology to support its breast cancer team, and data from over 2,000 patients indicates significant benefits in the consistency and quality of decision-making. Now, the team is embarking on a fully randomised clinical trial, and the software is being developed for a commercial launch through ISIS Innovations.

COSSAC isn’t just working on breast cancer: there are over 50 other applications at various stages of development, and they’re keen to make more. That’s too big a job for one small team, so they’ve developed OpenClinical.net, an open-source-style website that acts as a forum for experts to author, publish and maintain CREDO-style applications wherever they are in the world. It’s a big idea, and one that could transform patient care across the globe.

Funded by: Cancer Research UK, The Engineering and Physical Sciences Research Council and the Royal Free Hospital Charity.