RENOIR: An expert system using fuzzy logic for rheumatology diagnosis

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Abstract
A new expert system (ES) to aid the nonspecialist physician in diagnosing arthritis and collagen diseases has been developed. Here we present the structure of RENOIR and the results of its implementation. This rule-based ES has been programmed using the MILORD environment. This is a shell to develop ES using a closed set of linguistic labels to express uncertainty. A feature of RENOIR is its five levels of knowledge representation, which permits to build a very flexible knowledge base (KB) and express knowledge with high accuracy. Those rules directed to similar goals are grouped in modules to improve computational performance and for higher clarity of the KB. Control of the reasoning process is assured by several mechanisms, one of the main being metarules specifically designed for almost all the knowledge levels of the KB. We have used public domain knowledge (books, criteria tables) and personal heuristics from one of the authors (Belmonte-Serrano) to implement the KB of RENOIR. In its present form, our KB comprises 1 058 rules, 978 facts, 220 metarules, and 34 modules. A first validation process has shown good performance of the ES compared to 12 physicians with diverse levels of experience in rheumatic diseases. New ongoing versions of the system with improved interfaces and reasoning capabilities are expected before verifying RENOIR's clinical acceptability. © 1994 John Wiley & Sons, Inc.