A structural design of clinical decision support system for chronic diseases risk management

Open Medicine ◽  
2007 ◽  
Vol 2 (2) ◽  
pp. 129-139 ◽  
Author(s):  
Chi-Chang Chang ◽  
Chuen-Sheng Cheng

AbstractIn clinical decision making, the event of primary interest is recurrent, so that for a given unit the event could be observed more than once during the study. In general, the successive times between failures of human physiological systems are not necessarily identically distributed. However, if any critical deterioration is detected, then the decision of when to take thei ntervention, given the costs of diagnosis and therapeutics, is of fundamental importance This paper develops a possible structural design of clinical decision support system (CDSS) by considering the sensitivity analysis as well as the optimal prior and posterior decisions for chronic diseases risk management. Indeed, Bayesian inference of a nonhomogeneous Poisson process with three different failure models (linear, exponential, and power law) were considered, and the effects of the scale factor and the aging rate of these models were investigated. In addition, we illustrate our method with an analysis of data from a trial of immunotherapy in the treatment of chronic granulomatous disease. The proposed structural design of CDSS facilitates the effective use of the computing capability of computers and provides a systematic way to integrate the expert’s opinions and the sampling information which will furnish decision makers with valuable support for quality clinical decision making.

2021 ◽  
Vol 37 (S1) ◽  
pp. 21-22
Author(s):  
Carla Fernandez-Barceló ◽  
Elena Calvo-Cidoncha ◽  
Laura Sampietro-Colom

IntroductionIn the past decade, health technology assessment (HTA) has narrowed its scope to the analysis of mainly clinical and economic benefits. However, twenty-first century technology challenges require the need for more holistic assessments to obtain accurate recommendations for decision-making, as it was in HTA's foundations. VALues In Doing Assessments of health TEchnologies (VALIDATE) methodology approaches complex technologies holistically to provide a deeper understanding of the problem through analysis of the heterogeneity of stakeholders’ views, allowing for more comprehensive HTAs. This study aimed to assess a pharmaceutical clinical decision support system (CDSS) using VALIDATE.MethodsA systematic review of the empirical evidence on CDSS was conducted according to PRISMA guidelines. PubMed, the Cochrane Library, and Web of Science databases were searched for literature published between 2000 and 2020. Additionally, a review of grey literature and semi-structured interviews with different hospital stakeholders (pharmacists, physicians, computer engineers, etc.) were conducted. Content analysis was used for data integration.ResultsPreliminary literature results indicated consensus regarding the effectiveness of CDSS. Nevertheless, when including multistakeholder views, CDSS appeared to not be fully accepted in clinical practice. The main reasons for this appeared to be alert fatigue and disruption of workflow. Preliminary results based on information from the literature were contrasted with stakeholder interview responses.ConclusionsIncorporation of facts and stakeholder values into the problem definition and scoping for a health technology is essential to properly conduct HTAs. The lack of an inclusive multistakeholder scoping can lead to inaccurate information, and in this particular case to suboptimal CDSS implementation concerning decision-making for the technology being evaluated.


2019 ◽  
Vol 14 (2) ◽  
pp. 187-197
Author(s):  
Nur Raidah Rahim ◽  
Sharifalillah Nordin ◽  
Rosma Mohd Dom

  Clinical decision support system (CDSS) is promising in assisting physicians for improving decision-making process and facilitates healthcare services. In medicine, causality has become the main concern throughout healthcare and decision-making. Causality is necessary for understanding all structures ofscientific reasoning and for providing a coherent and sufficient explanation for any event. However, thereare lack of existing CDSS that provide causal reasoning for the presented outcomes or decisions. Theseare necessary for showing reliability of the outcomes, and helping the physicians in making properdecisions. In this study, an ontology-based CDSS model is developed based on several key concepts andfeatures of causality and graphical modeling techniques. For the evaluation process, the Pellet reasoneris used to evaluate the consistency of the developed ontology model. In addition, an evaluation toolknown as Ontology Pitfall Scanner is used for validating the ontology model through pitfalls detection.The developed ontology-based CDSS model has potentials to be applied in clinical practice and helpingthe physicians in decision-making process. Keywords: clinical decision support system, ontology, causality, causal reasoning, graphical modeling


2013 ◽  
Vol 1 (1) ◽  
Author(s):  
Sri Redjeki

Abstract. K-Nearest Neighbor (K-NN) is a method that uses a supervised algorithm where the results from the new sample test are classified based on the majority of the category on K-NN. K-Nearest Neighbor method (K-NN) is one of the clinical decision making method known as Clinical Decision Support System (CDSS). This Research employs the data of patients who have fever symptoms, in order to be classified into 10 possible diseases. The Research  objects are 82 data and 72 data are used for training while 10 data are used for testing. Value K=3, will be used for the best results in the disease grouping, with the accuracy value result of classification  is 97,2%. It is shown that the K-NN method is part of the CDSS because the value of accuracy that can be tolerated for grouping diseases reaches more than 97%.Keywords: Classification of disease, fever symptoms, K-NN. Abstrak. K-Nearest Neighbor (K-NN) adalah suatu metode yang menggunakan algoritma supervised dimana hasil dari sampel uji yang baru diklasifikasikan berdasarkan mayoritas dari kategori pada K-NN. Metode K-NN merupakan salah satu dari metode pengambilan keputusan klinik atau Clinical Decision Support System (CDSS). Penelitian ini menggunakan data pasien dengan gejala awal demam untuk mengelompokkan penyakit yang terdiri dari 10 penyakit. Obyek penelitian menggunakan data sebanyak 82 dengan 72 data digunakan untuk training dan 10 data digunakan untuk testing. Hasil terbaik pengelompokan penyakit menggunakan nilai K=3 dengan nilai akurasi hasil pengelompokkan sebesar 97,2%. Hal ini menunjukkan bahwa metode K-NN merupakan bagian dari CDSS karena nilai akurasi yang dapat ditoleransi untuk pengelompokan penyakit harus mempunyai nilai akurasi diatas 97%. Kata kunci: Gejala awal demam, K-NN, penyakit.


Author(s):  
Sarin Shrestha

Millions of people around the world have diabetes. It is the seventh leading cause of death in US. An advancement of technologies may serve as the backbone for controlling diseases. Computerizing healthcare is expected to be one of the powerful levers essential for significant transformation in the quality and cost of delivering healthcare. Data management and technology is essential for providing the ability to exchange data and information at the right place in the right time to the right people in the healthcare process, to enable informed decision-making, and to achieve better health outcomes. Clinical Decision Support System (CDSS) provides guidance specific to the patient, including importing/entering patient data into the CDSS application and providing relevant information like lists of possible diagnoses, drug interaction alerts, or preventive care reminders to the practitioner that assists in their decision-making. This chapter has focuses on the use of CDSS for diabetes prevention.


Diabetes ◽  
2019 ◽  
Vol 68 (Supplement 1) ◽  
pp. 1309-P
Author(s):  
JACQUELYN R. GIBBS ◽  
KIMBERLY BERGER ◽  
MERCEDES FALCIGLIA

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