Global optimization of case-based reasoning for breast cytology diagnosis

Case-based reasoning (CBR) is one of the most popular prediction techniques in medical domains because it is easy to apply, has no possibility of overfitting, and provides a good explanation for the output. However, it has a critical limitation - its prediction performance is generally lower than other AI techniques like artificial neural networks (ANN). In order to obtain accurate results from CBR, effective retrieval and matching of useful prior cases for the problem is essential, but it is still a controversial issue to design a good matching and retrieval mechanism for CBR systems. In this study, we propose a novel approach to enhance the prediction performance of CBR. Our suggestion is the simultaneous optimization of feature weights, instance selection, and the number of neighbors that combine using genetic algorithms (GA). Our model improves the prediction performance in three ways - (1) measuring similarity between cases more accurately by considering relative importance of each feature, (2) eliminating useless or erroneous reference cases, and (3) combining several similar cases represent significant patterns. To validate the usefulness of our model, this study applied it to a real-world case for evaluating cytological features derived directly from a digital scan of breast fine needle aspirate (FNA) slides. Experimental results showed that the prediction accuracy of conventional CBR may be improved significantly by using our model. We also found that our proposed model outperformed all the other optimized models for CBR using GA.