Del Fiol Guilherme, Haug Peter J
Biomedical Informatics Department, University of Utah, 4646 Lake Park Boulevard, Salt Lake City, UT 84120, USA.
J Biomed Inform. 2009 Feb;42(1):82-9. doi: 10.1016/j.jbi.2008.07.001. Epub 2008 Jul 13.
Clinicians face numerous information needs during patient care activities and most of these needs are not met. Infobuttons are information retrieval tools that help clinicians to fulfill their information needs by providing links to on-line health information resources from within an electronic medical record (EMR) system. The aim of this study was to produce classification models based on medication infobutton usage data to predict the medication-related content topics (e.g., dose, adverse effects, drug interactions, patient education) that a clinician is most likely to choose while entering medication orders in a particular clinical context.
We prepared a dataset with 3078 infobutton sessions and 26 attributes describing characteristics of the user, the medication, and the patient. In these sessions, users selected one out of eight content topics. Automatic attribute selection methods were then applied to the dataset to eliminate redundant and useless attributes. The reduced dataset was used to produce nine classification models from a set of state-of-the-art machine learning algorithms. Finally, the performance of the models was measured and compared.
Area under the ROC curve (AUC) and agreement (kappa) between the content topics predicted by the models and those chosen by clinicians in each infobutton session.
The performance of the models ranged from 0.49 to 0.56 (kappa). The AUC of the best model ranged from 0.73 to 0.99. The best performance was achieved when predicting choice of the adult dose, pediatric dose, patient education, and pregnancy category content topics.
The results suggest that classification models based on infobutton usage data are a promising method for the prediction of content topics that a clinician would choose to answer patient care questions while using an EMR system.
临床医生在患者护理活动中面临众多信息需求,而其中大部分需求未得到满足。信息按钮是一种信息检索工具,可通过在电子病历(EMR)系统中提供在线健康信息资源的链接,帮助临床医生满足其信息需求。本研究的目的是基于用药信息按钮使用数据生成分类模型,以预测临床医生在特定临床环境中输入用药医嘱时最有可能选择的与用药相关的内容主题(如剂量、不良反应、药物相互作用、患者教育)。
我们准备了一个包含3078个信息按钮会话以及描述用户、药物和患者特征的26个属性的数据集。在这些会话中,用户从八个内容主题中选择一个。然后将自动属性选择方法应用于该数据集,以消除冗余和无用的属性。精简后的数据集用于从一组先进的机器学习算法中生成九个分类模型。最后,对模型的性能进行测量和比较。
模型预测的内容主题与每个信息按钮会话中临床医生选择的内容主题之间的ROC曲线下面积(AUC)和一致性(kappa)。
模型的性能范围为0.49至0.56(kappa)。最佳模型的AUC范围为0.73至0.99。在预测成人剂量、儿童剂量、患者教育和妊娠类别内容主题的选择时,取得了最佳性能。
结果表明,基于信息按钮使用数据的分类模型是一种很有前景的方法,可用于预测临床医生在使用EMR系统时为回答患者护理问题而会选择的内容主题。