Web-Based Decision Support in Selecting Patients with Parkinson´s Disease for Deep Brain Stimulation

Parkinson´s disease is a progressive neurological disorder. Treatment of this disease is limited to dopamine replacement therapy, which successfully alleviates major signs of the disease. However, the treatment is associated with long-term side effects. Only a neurosurgical intervention is able to curtail the otherwise intolerable symptoms. One of the interventions is deep brain stimulation (DBS). Indications or contraindications for DBS surgery depend on (a) the course of previous treatment, (b) the patient´s current symptoms and signs, (c) the patient´s subjective quality of life, and (d) the anticipated prognosis of the disease. A web-based system, named FuzzyDBSexpert, was established to support the decision concerning the suitability of DBS surgery in a particular case. It consists of five main components: (1) the database that contains the patient´s medical data, (2) a user interface that implements the Unified Parkinson´s Disease Rating Scale and some further forms, (3) a knowledge base that contains fuzzy IF-THEN rules, (4) a medical specialist user interface, and (5) a fuzzy inference engine. The development of the system has been completed. Initial tests have shown that it is helpful for physicians treating patients with Parkinson´s disease as well as patients in making the decision as to whether DBS surgery should be performed.