A human-centric fuzzy decision support system for medical diagnosis using fuzzy cognitive maps

Clinical Snapshot

Key Findings

• P Value: Not applicable for methodological study

• Effect Size: Not quantified in traditional clinical terms

• Primary Outcome: Successful development of HCFDSS with proven theoretical convergence properties

• Nnt Or Sensitivity: Sensitivity analysis performed for expert intervention parameters and missing data scenarios

• Confidence Interval: Not reported

Clinical Application

Requires significant computational infrastructure and expert time for system training and maintenance Could align with TGA requirements for transparent medical device algorithms, but would need validation under Australian clinical guidelines and integration with existing electronic health records Clinicians requiring interpretable decision support in diagnostic scenarios with uncertain or evolving knowledge

Abstract

Medical decision support requires models that remain interpretable under uncertainty while still adapting to evolving data and expert knowledge. Fuzzy cognitive maps (FCMs) are attractive in this setting because they encode concept-level relations in a transparent graphical form. However, static expert-defined FCMs are often too rigid, whereas purely data-driven updates may weaken semantic consistency and drift away from clinically meaningful relations. This paper proposes a human-centric adaptive framework for fuzzy cognitive map-based medical decision support. The proposed Human-Centric Fuzzy Decision Support System (HCFDSS) combines data-driven weight adjustment with an explicit expert-correction operator, allowing the causal structure of the map to be refined without discarding domain knowledge. The method is formulated through a two-stage procedure: an inner reasoning loop updates concept activations for fixed weights, while an outer learning loop updates the weight matrix using a regularized objective together with bounded expert intervention. Under standard smoothness and boundedness assumptions, we establish sufficient conditions for stability of the inner reasoning dynamics and convergence of the outer weight-update operator. A numerical illustration shows how expert feedback can revise clinically important edges and alter the final diagnostic activation in an interpretable way. In addition, the paper reports a reproducible empirical evaluation involving synthetic medical scenarios and three public medical benchmark datasets from the UCI Machine Learning Repository, together with sensitivity analysis for expert intervention, preprocessing validation, robustness checks under missingness and imbalance, and expanded comparisons with mainstream machine-learning baselines. The proposed HCFDSS is positioned not as a replacement for high-capacity black-box predictors, but as a transparent and editable decision-support framework in which clinicians can inspect, question, and refine the learned relations. The main contribution of the present work is therefore methodological and theoretical, while the empirical evaluation clarifies the predictive-interpretability trade-off of the proposed framework under reproducible benchmark settings.

References

1. 1.Zakaria, A. (2026). A human-centric fuzzy decision support system for medical diagnosis using fuzzy cognitive maps. Scientific Reports. https://doi.org/10.1109/21.256541