Personalized medical care is the cornerstone of the health care system, paving the way for quality service in managing and treating various chronic non-communicable diseases. It is the process of providing management and treatment for individual patients based on their heterogeneity. It is also the reverse process of traditional understanding and treating diseases (Lasalvia, 2021).
Diet is one of the causes of health problems for human beings, particularly diabetes mellitus type 2 (T1DM) (Magkos et al., 2020). Dietary pattern is characterized by consuming a diverse selection of nutritionally distinct and wholesome foods that encourage nutrient adequacy and improved health outcomes. A healthy diet is characterized by a correct caloric intake and mainly focuses on consuming plant-based foods. Moreover, it favours the intake of unsaturated, rather than saturated, fats, low amounts of animal source foods, and small amounts of refined grains, highly processed foods and free sugars (Caprara, G.,2018).
Personalized medicine is the concept that deals with an individualized method for the management and treatment of the disease. It can change the prevention, prediction, and management ways of T2DM. It is also the lengthening and the evolution of the "one-size-fits-all" approach to patient management (Ramaswami et al., 2018). Unlike the "one-size-fits-all" approach, personalized medicine is mainly preventive and proactive rather than reactive (Mathur & Sutton, 2017).
One of the main goals of personalized medicine is to improve safety by lowering adverse drug reactions (ADRs), promoting a healthy diet, and identifying individuals who will benefit from medicine and those who will not. Its major goal is also to optimize personalized medical care and outcomes for each individual, which include treatments, pharmaceutical types, dosages, and/or prevention tactics that change from person to person, resulting in outstanding patient care (Goetz & Schork, 2018).
According to a study conducted by Torrent-Fontbona and López (2018), incorporating CBR for individualized medical care improves management and treatment processes. Using case-based reasoning assists health professionals in organizing and retrieving patients' unique characteristics information (patient heterogeneity) to provide tailored medical care and make judgments (Paruchuri & Granville, 2020; Bentaiba-Lagrid et al., 2020).
Personalized medicine has the potential to advance the performance of therapy for individual patients by distinguishing and capitalizing on patient heterogeneity. It is one of the main promises of the Human Genome Project (HGP), which began three decades ago and is now a new therapeutic paradigm. With its arrival in the era of developing drugs to suit all patients, often having to withdraw a promising new one because a minority of patients were at risk. Even though it had proved valuable for the majority, it was consigned to history, as were trial-and-error strategies being the predominant means of tailoring therapy(Leila El-Alti, 2019). However, it plays a crucial role in treating individuals through targeted treatment. It helps to reduce adverse drug reactions, reveal additional targeted uses for medicines and drug candidates, increase patient adherence to treatment, avoid invasive testing procedures and help to control the overall cost of health care (Personalized Medicine Coalition, 2017).
There is a scarcity of specialists in T2DM speciality. According to the data for 2021 and 2022 that was obtained from Jimma University Medical Center Health Management Information System (HMIS), the ratio of available specialists to the number of T2DM patients highly varies. For instance, there is one DM specialist for 346 patients who need continuous medical follow-up at different intervals. On the contrary, early management and treatment of T2DM are necessary, with effective management and treatment through personalized medical care that can deliver care to the right person according to their unique characteristics (patients' heterogeneity). Therefore, the development of an organized knowledge base greatly impacts the quality of the service delivery system, cost-effectiveness, and improvement of the overall management and treatment process in the health sector.
To the researchers' knowledge, there is no developed personalized medical care, a Case-based reasoning system that supports patients and health professionals to combat chronic non-communicable diseases, specifically T2DM, which leads to other complicated diseases. Hence, this study attempted to answer the following research questions:
1. What are the T2DM patients' cases suitable for developing a case-based reasoning system related to personalized medical care?
2. How would the acquired patients' cases be modelled and represented in developing a case-based reasoning system for personalized medical care for T2DM?
3. What types of knowledge are used to develop CBR for personalized medical care of T2DM?
4. To what extent does the developed prototype get user acceptance by the domain experts (health professionals) and T2DM patients in Jimma University's Medical Center?
OBJECTIVES OF THE STUDY
The main objective of this study is to design and develop the prototype of a Case-based reasoning system for personalized medical care for patients with T2DM. Specific objectives
Ø To identify patients cases suitable for personalized medical care by dietary pattern and drug therapy for patients with T2DM patients.
Ø To model and represent the acquired patients' cases to develop CBR personalized medical care for T2DM patients.
Ø To acquire tacit and explicit knowledge from domain experts and secondary data sources to develop CBR personalized medical care for T2DM patients.
To test and evaluate the performance and user acceptance of the designed CBR for personalized medical care for T2DM patients.