A web-based system for clinical decision support and knowledge maintenance for deterioration monitoring of hemato-oncological patients

被引：8

作者：

Wicht, Andreas ^{[1
]}

Wetter, Thomas ^{[1
,3
]}

Klein, Ulrike ^{[2
]}

机构：

[1] Univ Heidelberg Hosp, Inst Med Biometry & Informat, Med Informat Unit, D-69120 Heidelberg, Germany

[2] Univ Heidelberg Hosp, Dept Hematol Oncol & Rheumatol, D-69120 Heidelberg, Germany

[3] Univ Washington, Dept Med Educ & Biomed Informat, Seattle, WA 98195 USA

来源：

COMPUTER METHODS AND PROGRAMS IN BIOMEDICINE | 2013年 / 111卷 / 01期

关键词：

Clinical decision support system; Web-based system; Knowledge maintenance; Hematology; Hemato-oncological patients; Diagnosis; Deterioration monitoring; Sepsis; SIRS; Bacteremia; Fever of unknown origin (FUO); HEART-RATE;

D O I：

10.1016/j.cmpb.2013.02.007

中图分类号：

TP39 [计算机的应用];

学科分类号：

081203 ; 0835 ;

摘要：

We introduce a web-based clinical decision support system (CDSS) and knowledge maintenance based on rules and a set covering method focusing on the problem of detecting serious comorbidities in hemato-oncological patients who are at high risk of developing serious infections and life threatening complications. We experienced that diagnostic problems which are characterized by fuzzy, uncertain knowledge and overlapping signs, still reveal some kind of patterns that can be transferred into a computer-based decision model. We applied a multi-stage evaluation process to assess the system's diagnostic performance. Depending on how system behavior was compared to presumably correct judgment of a case the correctness rate for closed cases with all data available varied between 58% and 71%, the overall rate after critical review was 84%. However, the real time behavior of our approach which data becoming available as time passes still has to be evaluated and observational studies need to be conducted. (C) 2013 Elsevier Ireland Ltd. All rights reserved.

引用

页码：26 / 32

页数：7

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