# Instance-Based Learning Following Physician Reasoning for Assistance during Medical Consultation
## 5 Medical Consultation Flows
### Selecting an Already Defined Case Type
Another possibility for future work is related to enhance the accuracy of the learning method by improving the comparison between units of thought (clinical phrases). The weights of the clinical sections of case types used in the experimental analysis were defined simply, according to qualitative ranges of medical relevance. Consequently, a future work is to enhance the results by considering more accurate weights of medical relevance. ## 9 Conclusions

This work presented a novel approach to represent clinical knowledge, which supports an appropriate methodology for recording medical consultations. An instance-based learning method was also proposed, aiming at providing pertinent suggestions for physicians. Different scenarios of medical consultations were modeled to address the diversity of situations of physician workday, including multiple diagnoses and the attention of chronic patient. The proposed formal structure was also designed to use standard health terminology and codification. The approach was validated on a real case study involving 250 real instances constructed by advanced medical students. The proposed instance-based learning method was able to generate suggestions in reasonable execution times, even faced with large volumes of data. A total of 62% of the participants reduced the writing time of their medical consultations, which demonstrated that the approach was useful to accelerate the clinical registration process. Furthermore, results indicated it was appropriate to follow physician reasoning, especially during medical consultations. More than 73% of the participants approved a prototype following the proposed approach for assistance during consultations. The proposed clinical representation supported by the learning method contributed to generate medical records faster than when using mainstream EMR systems. Overall, the proposed approach is a first step to explore new ways to foster physician thinking, overcoming difficulties of template-based clinical systems that are not designed from the medical point of view. Conceptualization, M.G. and F.S. ; methodology, M.G. ; software, M.G. ; validation, M.G. and F.S. ; formal analysis, M.G. and S.N. ; investigation, M.G. and S.N. ; resources, M.G. and F.S. ; data curation, M.G. ; writing--original draft preparation, M.G. and S.N. ; writing--review and editing, S.N. ; visualization, S.N. ; supervision, F.S. and S.N. ; project administration, M.G. ; funding acquisition, M.G., F.S. and S.N. All authors have read and agreed to the published version of the manuscript. This research was partially funded by ANNI, Uruguay and Infor-Med Corporation, Argentina. Part of the publication fee was funded by PEDECIBA, Uruguay. The work of [PERSON] was partly funded by ANNI and PEDECIBA, Uruguay. The authors declare no conflict of interest. ## References

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