A consensus approach to maintain a knowledge based system in pathology.

The IDEM (Images and Diagnosis from Example in Medicine) software is a computerized environment able to store unambiguous descriptions of histopathologic images from pathologists. Medical imaging could benefit from such environments if they can easily and continuously be maintained. Within the IDEM environment, we developed a knowledge management module coupled with a consensus module to support knowledge acquisition and maintenance by the experts of the domain. Two pathologists, a senior and junior pathologist, reviewed fifty-three cases of breast pathology. Our findings indicate 1) that the IDEM knowledge management module allows experts to describe images by selecting terms and defining new ones if necessary, allowing the construction of a glossary for the domain and 2) that the consensus module, developed to store valid multi-experts cases, contributes also to validate new terms of the glossary and to refine semantic distance between terms. Such methodology could be applied to others highly evolving medical domains.