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. 2022 Aug 13;22(1):218.
doi: 10.1186/s12911-022-01963-x.

Fuzzy constraint-based agent negotiation framework for doctor-patient shared decision-making

Kaibiao Lin  1   2 , Yong Liu  3 , Ping Lu  4   5 , Yimin Yang  6 , Haiting Fan  6 , Feiping Hong  7
Affiliations

Fuzzy constraint-based agent negotiation framework for doctor-patient shared decision-making

Kaibiao Lin et al. BMC Med Inform Decis Mak. .

Abstract

Background: The clinical practice of shared decision-making (SDM) has grown in importance. However, most studies on SDM practice concentrated on providing auxiliary knowledge from the third-party standpoint without consideration for the value preferences of doctors and patients. The essences of these methods are complete and manual negotiation, and the problems of high cost, time consumption, delayed response, and decision fatigue are serious.

Methods: In response to the above limitations, this article proposes a fuzzy constraint-directed agent-based negotiation and recommendation framework for bilateral and multi-issue preference negotiation in SDM (PN-SDM). Its purpose is to provide preference information and intellectualize PN-SDM to promote SDM practice. We modeled PN-SDM problems as distributed fuzzy constraint satisfaction problems and designed the doctor agent and patient agent to negotiate on behalf of the doctor and patient. The negotiation result was then transformed into treatment plans by the recommendation model. The proposed negotiation and recommendation models were introduced in detail by an instance.

Results: The proposed method with different strategies and negotiation pairs achieves good performance in terms of negotiation running time, negotiation rounds, and combined aggregated satisfaction value. Specifically, it can feasibly and effectively complete multiple rounds of PN-SDM in a few seconds and obtain higher satisfaction.

Conclusion: The experimental results indicate that the negotiation model can effectively simulate preference negotiation and relieve the pressure of increasing issues. The recommendation model can assist in decision-making and help to realize SDM. In addition, it can flexibly cope with various negotiation scenarios by using different negotiation strategies (e.g., collaborative, win-win, and competitive).

Keywords: Agent; Fuzzy constraint; Negotiation; Shared decision-making; Treatments recommendation.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Problem conversion
Fig. 2
Fig. 2
Agent-based negotiation for the bilateral PN-SDM
Fig. 3
Fig. 3
Negotiation process between the DA and the PA
Fig. 4
Fig. 4
Treatment recommendation model for the PN-SDM
Fig. 5
Fig. 5
Similarity between negotiation results and treatments of the FCAN with collaborative strategy
Fig. 6
Fig. 6
The combined ASV for different negotiation pairs on different issues
Fig. 7
Fig. 7
The running time for different negotiation pairs on different issues
Fig. 8
Fig. 8
The negotiation rounds for different negotiation pairs on different issues
Fig. 9
Fig. 9
The group’s avg. combined ASV, running time, and negotiation rounds on different issues
See this image and copyright information in PMC

References

    1. Charles C, Gafni A, Whelan T. Shared decision-making in the medical encounter: what does it mean? (or it takes at least two to tango) Social Sci Med. 1997;44(5):681–692. doi: 10.1016/S0277-9536(96)00221-3. - DOI - PubMed
    1. Barry MJ, Edgman-Levitan S. Shared decision making-the pinnacle of patient-centered care. N Engl J Med. 2012;366(9):780–781. doi: 10.1056/NEJMp1109283. - DOI - PubMed
    1. Veatch RM. Models for ethical medicine in a revolutionary age. What physician-patient roles foster the most ethical relationship? Hastings Cent Rep. 1972;2(3):5–7. doi: 10.2307/3560825. - DOI - PubMed
    1. Moulton B, King JS. Aligning ethics with medical decision-making: the quest for informed patient choice. J Law Med Ethics. 2010;38(1):85–97. doi: 10.1111/j.1748-720X.2010.00469.x. - DOI - PubMed
    1. Jin-Qing G, Xu-Zhi M, Wei Y. Discussing the emergence of contradiction between doctors and patients and development of harmonious relation-ship. Chin Health Serv Manage. 2011;28(3):181–183.

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