Abstract: This paper describes a prototype computer aided diagnosis system to assist in the interpretation of mammograms. The distinctive feature of our work is the combination of image processing and decision support. We wish, in our system, to relate the data in a digital image to a decision contained in a clinical guideline describing a patient's management. Our system is designed to present a user with sets of arguments for each of the possible interpretations of a feature detected on the image and for each of the possible management options that might be followed in handling the patient's care. We have carried out an extensive knowledge elicitation exercise, involving the analysis of 'think out loud' protocols obtained from expert radiologists interpreting mammograms form a carefully selected test set. The results of this analysis reveal which terms capture the most salient characteristics of calcifications. These terms will be used to construct the arguments used in the decision support provided by CADMIUM II. The final element of CADMIUM II is a library of image processing algorithms. A set of different approaches to the detection and characterization of calcifications has been implemented. The image processing is used to provide a quantitative estimate of the evidence that an image contains in support of an argument. !16
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