Latent class model based diagnostic system utilizing traditional Chinese medicine for patients with systemic lupus erythematosus

Systemic lupus erythematosus (SLE) can affect nearly any organ system, and is frequently an evolving disease with varied manifestations. Traditional Chinese medicine (TCM) physicians have identified different SLE patterns that they have difficulty summarizing, but the latent class model helps solve this problem. This study applies the latent class model and disease pattern coding system (B-code) to design a TCM diagnostic expert system. This study gathered 2047 valid records and classified three clusters of main disease patterns. Compared with the experience of the TCM expert, the accuracy rate of the expert system reached 77.47%. The results show that this diagnostic system performed well in identifying the disease patterns of SLE and may be clinically useful for TCM physicians. Systemic lupus erythematosus (SLE) is a multisystem autoim-mune disorder with variable manifestations, the etiology of which has not yet been fully described but is believed to be multifactorial (Danchenko, Satia, & Anthony, 2006). Pathogenic autoantibodies are the primary cause of tissue damage in patients suffering SLE. These antibodies are produced via complex mechanisms involving every major facet of the immune system (Rahman & Isenberg, 2008). SLE can affect almost any organ system and is frequently an evolving disease, the manifestations of which develop over months or years. The disease course is variable and unpredictable (Maddison, 2002). Although glucocorticoid therapy is the cornerstone of treatment and intravenous methylprednisolone continues to be widely used in clinical practice (Parker & Bruce, 2007), over 90% of patients have reported at least one adverse event associated with glucocorticoid use (Curtis et al., 2006). Infection, which is frequently attributed to glucocorticoid and other immunosuppressant medications, is a major cause of death in SLE (Bernatsky et al., 2006). Despite the improved survival in patients with SLE, there is currently neither curative nor satisfactory treatment available (Mcelhone, Abbott, & Teh, 2006). Consequently, some patients with SLE seek help via traditional Chinese medicine (TCM). Because the presentations of SLE vary, ranging from rash and arthritis through anemia and thrombocytopenia to serositis, nephritis, seizures, and psychosis, SLE is considered as one of the differential diagnosis in virtually any patient presenting with one of these clinical problems, particularly in female patients between 15 and 50 years of age (Rahman & Isenberg, 2008). Conventional modern medicine has difficulty in accurately diagnosing SLE, and so does TCM, which uses data collected by the naked senses of physicians, including ''inspection " , ''listening/ smelling " , …