Journal of Applied Computer Science & Mathematics, no.

15 (7) /2013, Suceava

Evolutionary Forecasting Method of Treatment Results

Irina TSYGANKOVA
St. Petersburg Institute for Informatics and Automation of the Russian Academy of Sciences, Laboratory of Applied
Informatics, Russia
pallada-ltd@infopro.spb.su

Abstract–Processing method of poorly formalized Realization of these techniques is impossible without

multivariable arrays of biomedical information, based on
evolutional method for solving of extreme tasks of multivariable
function, is presented in the article. Method allows predicting
treatment results take account of biomedical and social features
of the patients. Method allows selecting the weights of input
parameters without preliminary reduction of the
multidimensional feature space which eliminates the loss of
important information and to identify weak links in these
information arrays. Results of numerical experiments which
have shown high efficiency of method are presented. Value of
the mean average prognostication error amounted to 10-17%.
Developed method can be used in various subject areas in which
information about the objects kept in the large volume data sets,
are described in the protocols of "input-output", and for them
the hypothesis of monotony of the decision-making in the local
area is valid.
Keywords: data processing, evolutionary method, biomedical
information, forecasting, program complex, support decision
making.
I. INTRODUCTION
Growth of the requirements to the quality of life,
appearance of the new diagnostic and medical technologies
led to sharp increase in the prices for medical services. This
dramatically aggravated the problem of optimizing the costs
for disease treatment and prevention both for individual
patients and for medical organizations of different levels. The
solution to this problem can be achieved only by utilizing
modern techniques of optimization and forecasting the results
of each treatment with account for medical and biological as
well as social characteristics of every single patient.
The development of computer and information
technologies allows at present stage switching to solving the
tasks of medical forecasting by means of involvement of the
intellectual data analysis techniques [1-3]. The particularities
of the real medical and biological data are high dimensions
and diversity of data types, a large number of “noise” and
duplicated characteristics, omitted and abnormal values. In
this situation the techniques based on the evolutionary
approach and unlike the traditional techniques of optimal
solution seeking aimed at achievement of the best (the most
acceptable) solution in comparison with those earlier
obtained or set as an initial value become more efficient.
introduction of modern informational systems supporting the
process of solution-making in the ordinary medical practice.
The utilization of such systems in the work of a modern
doctor will improve the quality of the medical services, make
easier the work of the medical staff, improve the quality of
the patients’ lives as well as substantially reduce the costs for
disease treatment and prevention.
II. TASK DESCRIPTION
The present article is focused on the task of forecasting the
treatment results with involvement of the set treatment
technique by the example of the chronic skin disease
psoriasis. Initial information about the patients is presented in
the form of the numerical tables “object – property” with the
description of the input and output parameters (peculiarities,
characteristics) of the patients. The input parameters include
individual data concerning each patient: anamnesis,
associated diseases, clinical and functional, metabolic and
immunological indices, treatment technique. The output
(target) parameters are duration of the patient’s stay in the
hospital (number of patient days), duration of the treatment
till the improvement of the patient’s state (treatment
efficiency), duration of the remission period, presence (or
absence) of the typical residual lesions on the skin, number of
the disease exacerbation per year. Input parameters to a
different extent influence the output ones, but which of them
exert more significant influence on the target parameters and
by which model the relation of their influence is described, is
still unknown.
In a general case the initial information about the objects is
presented as a matrix
Z  Z1 , Z 2 ,, Z i ,, Z N 
i  i1 i2 ij iM 
where Z  z , z ,  , z ,  , z  is a vector of parameters
of the i -th object. Each zij parameter takes a value from the
set of permissible values. The totality of objects parameters is
divided into input V  v1 , v2 ,  , vt  and output
Y   y1 , y2 ,  , y s  parameters. Input parameters are diverse;
they are measured on quantitative and qualitative scales.
Denote by X  x1 , x2,  , xm  parameters such that are
measured in quantitative scales. Denote by

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U  u1 , u 2 ,  , u h  parameters such that are measured in  

method. Denote by W  w1 , w2 ,  , w j ,  , wm weight vector
qualitative (nominal and serial) scales. Vector output where w j ,  j  1,2,  , m  – weight factors of input
parameter Y is measured in a quantitative scale.
It is required to forecast with the acceptable accuracy the parameters.
values of the unknown output parameters of a new object Each object can be presented as a vector of
multidimensional space of quantitative parameters
according to its known input ones.
This problem is badly formalized task because all the 
Oi  x1 , x2 ,  , x j ,  , xm , y 
information about the objects is represented only by the set of where xi is input parameters of the object, y is output
parameters that you cannot say with any certainty that they
(targeted) parameter of the object, p  m  1 is total number
are complete, non-contradictory and non-distorted. With
these initial data we will use the model of “black box” and of multidimensional space parameters. In this case the task of
when developing the algorithms for data analysis we will use determining the unknown parameter by known input
only the arrays of precedents and the hypothesis about the parameters is reduced to the interpolation function y  f  X 
monotony of the solution space that is “similar input given at the nodes p –dimensional irregular grid.
situations lead to the similar output responses of the system”. Since the level of smoothness of f  X  is unknown in
III. EVOLUTIONARY PROCESSING METHOD order to interpolate it within the whole area of determination
it is suggested to use a function of the type
Solution of the projection task using the proposed method f  X   y r d  X , W 
consists of several stages: where d is measure of proximity between objects.
 preliminary processing of data, “Weighed” Euclidean distance is considered as the measure
 selection of weight parameters in the learning process, of proximity between the objects i and l
 prediction of targeted parameters.
 w j x ji  x jl  ,0  w j  1
m
Preliminary processing stage includes: structuring of data, d il  2
(1)
j 1
revealing and elimination of anomalous and missed values,
coding and normalizing of data measured in continuous Weight factors are selected using the Monte-Carlo method.
scales. Parameters measured in discrete scales and possessing In order to ensure the required accuracy of projected
more than two gradations are transformed into a set of binary parameter computation let us introduce a criterion which
values. minimizes the average absolute forecast error
 
Let us introduce vector G  g1 , g 2 ,  , g j ,  , g K where
Qw 
1 N0
 yi  yri d   min (2)
g j  j  1,2,  , K  represents binary features of objects. At N 0 i 1

the stage of preliminary processing the whole set of the
objects is divided into subsets (samples) according to the g j
values. Total number of these samples will be C K where K
– the number of binary values, C – the number of variants
(alternatives) of object group by each binary feature g j . The
following variants of objects groups are possible:
– objects are included in the selection irrespectively of the
value g j ,
– in the selection there are objects for which g j  0 ,
– in the selection there are objects for which g j  1 .
The same object might be included in several samples
which contain various numbers of objects. Further in only the
informatively valuable selections are used in which the
number of objects is significantly more than the number of
quantitative input parameters.
At the next stage (training period) weights of input
parameters X are defined for each informatively valuable
selection. Determination of weight factors is based on the
evolutional approach to the resolution of extreme
multivariable function problems and the random search
where y  yr d  is the difference between the observed and
calculated values of the output parameter, N 0 is analyzed
sample size.
If necessary predict multiple output parameters significant
coefficients b j ,  j  1,2,  , s  is given a priori for each
predicted parameter. Values of coefficients b j are selected
from the interval 0,1 and the normalizing condition should
be observed for them
s
bj  1
j 1
where  s is number of predicted parameters. Then the
criterion (2) can be written as
1 N0 s  j  j
Qw    b j yi  yri d   min (3)
N 0 i 1 j 1
In order to determine the estimated values of yri let us
reduce the task of multivariate interpolation grid function
y  f  X  to one-dimensional task of extrapolation function
y ri d  , i  1,2,  , N 0  . For this purpose according to the
formula (1) the distances are determined between each point

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 Journal of Applied Computer Science & Mathematics, no. 15 (7) /2013, Suceava
i of the spatial grid and other points where the values of
function y are determined. Then the distances are ranked in
the increasing order. Denote
 
Di  d i1 , d i 2 ,  , d il ,  d i  N 0 1 ranked distance vector.
Then, having an array of number pairs d k , yk 
k  1,2,  , N 0  1 the problem of extrapolation of discrete
dependence y d k  is solved by the continuous function
yr d  . In the course of creation of the approximating
function yr d  only n -nearest points are used. In a general
case the value is determined in the process of preliminary
computation experiment. As a model for approximation a
quadratic polynomial is used
y r d    ai d i .
2
i 0
Factors ai are determined based on the conditions of
functional minimization
E    y k  y r d k , ai 2  min .
n
k 1
Iterative refinement criterion Qw calculated according to
the formula (2) or (3), continues as long as:
 number of iterations in the course of which the solution
does not improve will exceed the predetermined value,
 calculated value of the average absolute projected error
falls below the a priori determined value of the acceptable
error,
 maximum time of computation is exceeded.
The evolutionary computation process maybe stopped and
resumed at any time.
The next stage of task solution is the use of the obtained
results in the process of learning to predict the unknown
target parameters of the new object. To do this, first, identify
those informative sampling which gets a new object
considering its qualitative characteristics. The sample in
which the prediction error has the smallest value is used for
further analysis. Computation of each targeted parameter of
the new objet is reduced to the of extrapolation function
y r d  in the proximity of this object grid point.
After the output parameters of the new object become
known, the object contributes to the training samples, and the
weight factors are refined according to the above method.
Thus, the forecasting of target parameters is not a one-time
operation but a process in the course of which the initial data
are continuously collected, refined and consolidated,
refinement of the weight factors and verification of the results
are performed.
IV. SOFTWARE SYSTEM
The developed method of forecasting was implemented in
the software system to support making medical decisions [4].
Software system is intended to function in Windows
 
environment. A modular-type object-based approach is used
in the development of the software system; it allows creating
by easily modifiable applied software packages. The software
system consists of a database, a package of software modules
and user interface. Access to the software system is set
according to the user-defined role. The database is
represented by an array of medical-biological information
about patients, medical treatment methods and results. A
relation model is used for structuring of information. It
allows naturally displaying the data in a table of “object-
property” type. Data arrays are stored in electronic tables of
Excel format.
Data exchange between the electronic table and the
software module is performed using the process automation
mechanism OLE.
The software package includes:
 initial data preliminary processing module,
 learning module which provides the calculation of weights
of input parameters,
 forecasting module of a new patient output parameters
based on his/her input parameters.
Software modules are implemented in the environment of
object-oriented programming language C++Builder.
User interface of the software system ensures the input of
initial data and the presentation of the calculation results.
Interface has a user-friendly display which is familiar to the
users. Object-oriented approach to the interface structure and
the use of graphic components included in the libraries of
Windows and C++Builder operating systems allows
promptly modifying the interface according to the
requirements of the users.
Protected hierarchical access to the information databases
and software modules of the following categories of users is
provided: doctor, administrator, developer. Doctor enters and
edits initial data of the patients, selects the method of
treatment from regulated list and obtains estimated result of
the new patient forecasted parameters. It is possible to review
in the interactive mode a table with the description of input
and output parameters of patients who completed the
treatment and have parameters similar to the ones of the new
patients.
Administrator updates and maintains databases, performs
the estimation procedures for the selection of weight factors
for various combinations of qualitative values of medical-
biological data.
Developer has a full access to the software system and an
opportunity to modify the software code.
V. NUMERICAL EXPERIMENT
In order to estimate the efficiency of the developed
forecasting method a numerical experiment was conducted
with using of real biomedical data of patients with psoriasis.
These data were obtained in medical facilities located in St.
Petersburg. Described above software system to support the
medical decision-making was used to conduct numerical
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experiments. The data on 308 patients were included in the Reliability of obtained results is confirmed by the
initial sample based on which the research was conducted. calculations based on the control sample.
Out of them 45 records were selected at random, they were in
the control sample, and the remaining 263 patients were VI. CONCLUSION
included in learning sample. The total number of numerical Suggested prognostication method may be used in various
parameters which characterize each patient is 44. Out of them application environments where application data are
39 are input parameters, 5 – output parameters. The summarized in the information arrays of large volume,
forecasting task is solved separately for each output defined in “input-output” protocols, and the hypothesis of the
parameter. Summarized results of calculations aimed at the monotony decision holds for them in the local area. The
assessment of the target parameters prognostication are developed method of medical-biological information
shown in the Table I. processing allows selecting weight coefficients of input
Conducted calculations aimed at the assessment of the parameters without a reduction of the attribute space
target parameters prognostication demonstrated a rather high dimensionality which, in its turn, allows excluding a loss of
efficiency of the suggested method. The value of the mean notional information and revealing weak connections in the
average prognostication error amounted to 10-17%. information arrays under consideration.
TABLE I
RESULTS OF FORECAST OUTPUT PARAMETERS REFERENCES
Forecasted parameter Average forecast error
[1] Z.Michalewicz Genetic algorithms + data structures = evolution
Treatment period in programs. Berlin etc.: Springer, 1996.
0,101
hospital(number of bed-days) [2] A.A.Freitas Data Mining and Knowledge Discovery with Evolutionary
Algorithms. Berlin etc.: Springer, 2002.
Effect of treatment (the period
0,112 [3] I.H.Witten, E.Frank, M.A.Hall Data mining: Practical machine learning,
of acute stage)
tools and techniques. Elsevier, 2011.
Number of flare-ups per year 0,139 [4] I.A.Tsygankova “Program complex system of decision-making,”
Software & Systems. Moscow, pp. 155-158, N 4, 2008 [in Russian with
Degree of resolution (residual English abstract]
0,163
lesions on the skin)
Period of remission 0,167

I. Tsygankova is Senior Researcher at the St. Petersburg Institute for Informatics and Automation RAS, Laboratory of Applied Informatics,
Russia. She has obtained her Ph.D. in Computer Science and Engineering in the year 1992.Her research interests include: Data mining with
evolutionary algorithms, Software engineering, Forecasting and Classification, Machine Learning, Database systems.

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