Rossille Delphine, Laurent Jean-François, Burgun Anita
Laboratoire d'Informatique Médicale, Université de Rennes 1, 2 avenue du Professeur Léon Bernard, 35043 Rennes Cedex, France.
Int J Med Inform. 2005 Mar;74(2-4):299-306. doi: 10.1016/j.ijmedinf.2004.06.005.
In most hospital medical units, multidisciplinary committees meet weekly to discuss their patients' cases. The medical experts base their decisions on three sources of information. First, they check if their patient complies with existing guidelines. Failing these, the medical experts will base their therapeutic decisions on the cases of similar patients that they have treated in the past. We propose a multi-modal reasoning decision-support system based on both guideline and case series, which will automatically compare the patient's case to the corresponding guideline, then to other cases, and retrieve similar cases. The general structure of the system is presented here, the domain of application being oncology. As the patients' records are not currently stored in a database in a format which is directly accessible, an object-oriented model is proposed, which includes prognosis factors currently tested in clinical trials, well-established ones, and a description of the illness episodes. The system is designed to be a data warehouse. Such a system does not exist in the literature. Future work will be needed to define the similarity measures, and to connect the system to the current database.
在大多数医院的医疗科室,多学科委员会每周都会开会讨论患者病例。医学专家的决策基于三种信息来源。首先,他们检查患者是否符合现有指南。若不符合,医学专家将根据他们过去治疗过的类似患者的病例来做出治疗决策。我们提出了一种基于指南和病例系列的多模态推理决策支持系统,该系统将自动把患者病例与相应指南进行比较,然后与其他病例进行比较,并检索相似病例。这里介绍了该系统的总体结构,其应用领域为肿瘤学。由于目前患者记录并非以直接可访问的格式存储在数据库中,因此提出了一种面向对象模型,其中包括目前在临床试验中测试的预后因素、已确立的因素以及疾病发作的描述。该系统被设计为一个数据仓库。文献中不存在这样的系统。未来需要开展工作来定义相似性度量,并将该系统与当前数据库连接起来。