Adaptative Clinical Decision Support System using Machine Learning and Authoring Tools

2020 ◽  
Author(s):  
Jon Kerexeta ◽  
Jordi Torres ◽  
Naiara Muro ◽  
Kristin Rebescher ◽  
Nekane Larburu
Keyword(s):  
Machine Learning ◽  
Decision Support ◽  
Decision Support System ◽  
Clinical Decision Support ◽  
Support System ◽  
Clinical Decision Support System ◽  
Clinical Decision ◽  
Authoring Tools

scholarly journals Development of machine learning-based clinical decision support system for hepatocellular carcinoma

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Gwang Hyeon Choi ◽  
Jihye Yun ◽  
Jonggi Choi ◽  
Danbi Lee ◽  
Ju Hyun Shim ◽  
...  
Keyword(s):  
Machine Learning ◽  
Hepatocellular Carcinoma ◽  
Decision Support ◽  
Decision Support System ◽  
Treatment Option ◽  
Clinical Decision Support ◽  
Support System ◽  
Initial Treatment ◽  
Clinical Decision Support System ◽  
Clinical Decision

Abstract There is a significant discrepancy between the actual choice for initial treatment option for hepatocellular carcinoma (HCC) and recommendations from the currently used BCLC staging system. We develop a machine learning-based clinical decision support system (CDSS) for recommending initial treatment option in HCC and predicting overall survival (OS). From hospital records of 1,021 consecutive patients with HCC treated at a single centre in Korea between January 2010 and October 2010, we collected information on 61 pretreatment variables, initial treatment, and survival status. Twenty pretreatment key variables were finally selected. We developed the CDSS from the derivation set (N = 813) using random forest method and validated it in the validation set (N = 208). Among the 1,021 patients (mean age: 56.9 years), 81.8% were male and 77.0% had positive hepatitis B BCLC stages 0, A, B, C, and D were observed in 13.4%, 26.0%, 18.0%, 36.6%, and 6.3% of patients, respectively. The six multi-step classifier model was developed for treatment decision in a hierarchical manner, and showed good performance with 81.0% of accuracy for radiofrequency ablation (RFA) or resection versus not, 88.4% for RFA versus resection, and 76.8% for TACE or not. We also developed seven survival prediction models for each treatment option. Our newly developed HCC-CDSS model showed good performance in terms of treatment recommendation and OS prediction and may be used as a guidance in deciding the initial treatment option for HCC.

scholarly journals A New Real Time Clinical Decision Support System Using Machine Learning for Critical Care Units

IEEE Access ◽  
2020 ◽  
Vol 8 ◽  
pp. 185676-185687
Author(s):  
Noha Ossama El-Ganainy ◽  
Ilangko Balasingham ◽  
Per Steinar Halvorsen ◽  
Leiv Arne Rosseland
Keyword(s):  
Machine Learning ◽  
Critical Care ◽  
Decision Support ◽  
Decision Support System ◽  
Real Time ◽  
Clinical Decision Support ◽  
Support System ◽  
Clinical Decision Support System ◽  
Clinical Decision ◽  
Critical Care Units

scholarly journals Reducing drug prescription errors and adverse drug events by application of a probabilistic, machine-learning based clinical decision support system in an inpatient setting

2019 ◽  
Vol 26 (12) ◽  
pp. 1560-1565 ◽  
Author(s):  
G Segal ◽  
A Segev ◽  
A Brom ◽  
Y Lifshitz ◽  
Y Wasserstrum ◽  
...  
Keyword(s):  
Machine Learning ◽  
Decision Support ◽  
Decision Support System ◽  
Clinical Decision Support ◽  
Support System ◽  
Clinical Decision Support System ◽  
Drug Prescription ◽  
Clinical Decision ◽  
Inpatient Setting ◽  
Probabilistic Machine Learning

Abstract Background Drug prescription errors are made, worldwide, on a daily basis, resulting in a high burden of morbidity and mortality. Existing rule-based systems for prevention of such errors are unsuccessful and associated with substantial burden of false alerts. Objective In this prospective study, we evaluated the accuracy, validity, and clinical usefulness of medication error alerts generated by a novel system using outlier detection screening algorithms, used on top of a legacy standard system, in a real-life inpatient setting. Materials and Methods We integrated a novel outlier system into an existing electronic medical record system, in a single medical ward in a tertiary medical center. The system monitored all drug prescriptions written during 16 months. The department’s staff assessed all alerts for accuracy, clinical validity, and usefulness. We recorded all physician’s real-time responses to alerts generated. Results The alert burden generated by the system was low, with alerts generated for 0.4% of all medication orders. Sixty percent of the alerts were flagged after the medication was already dispensed following changes in patients’ status which necessitated medication changes (eg, changes in vital signs). Eighty-five percent of the alerts were confirmed clinically valid, and 80% were considered clinically useful. Forty-three percent of the alerts caused changes in subsequent medical orders. Conclusion A clinical decision support system that used a probabilistic, machine-learning approach based on statistically derived outliers to detect medication errors generated clinically useful alerts. The system had high accuracy, low alert burden and low false-positive rate, and led to changes in subsequent orders.

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