Implementing a Case-Based Reasoning System for End-of-Life Cancer Care: Improving Palliative Care Planning for Pain and Symptom Management

In palilative medicine, health care professionals aim to provide end-of-life cancer patients with a plan of care to minimize pain and manage symptoms, while providing psychosocial and educational support to patients and their families. Unfortunately, it has been reported that terminally ill cancer patients often experience unnecessary suffering due to ineffective symptom management as they near end-of-life. Recent advances in health informatics have motivated health care institutions to take advantage of decision support systems that assist health care professionals with evidence-based decision making. In this paper, we present a clinical decision support system that incorporates case based reasoning. Case based reasoning is a unique problem-solving methodology that is predicated upon reusing previously solved patient cases to formulate solutions to new, unsolved patient cases. This reasoning methodology emulates the human problem solving process, and has been highly valuable for medical problem solving. Patient cases (N = 277) for this research were provided by the Victoria Hospice Society and the University of Victoria, Canada. It is anticipated that this user-friendly, web-based CBR system will improve decision making for pain and symptom management for end-of-life cancer patients.