Department of Psychology, University of Nebraska, Lincoln, NE, USA.
Schizophr Bull. 2011 Sep;37 Suppl 2(Suppl 2):S129-37. doi: 10.1093/schbul/sbr080.
Personalization of treatment is a current strategic goal for improving health care. Integrated treatment approaches such as psychiatric rehabilitation benefit from personalization because they involve matching diverse arrays of treatment options to individually unique profiles of need. The need for personalization is evident in the heterogeneity of people with severe mental illness and in the findings of experimental psychopathology. One pathway to personalization lies in analysis of the judgments and decision making of human experts and other participants as they respond to complex circumstances in pursuit of treatment and rehabilitation goals. Such analysis is aided by computer simulation of human decision making, which in turn informs development of computerized clinical decision support systems. This inspires a research program involving concurrent development of databases, domain ontology, and problem-solving algorithms, toward the goal of personalizing psychiatric rehabilitation through human collaboration with intelligent cyber systems. The immediate hurdle is to demonstrate that clinical decisions beyond diagnosis really do affect outcome. This can be done by supporting the hypothesis that a human treatment team with access to a reasonably comprehensive clinical database that tracks patient status and treatment response over time achieves better outcome than a treatment team without such access, in a controlled experimental trial. Provided the hypothesis can be supported, the near future will see prototype systems that can construct an integrated assessment, formulation, and rehabilitation plan from clinical assessment data and contextual information. This will lead to advanced systems that collaborate with human decision makers to personalize psychiatric rehabilitation and optimize outcome.
个性化治疗是改善医疗保健的当前战略目标。综合治疗方法，如精神康复，受益于个性化，因为它们涉及将各种治疗选择与个体独特的需求特征相匹配。个性化的需求在严重精神疾病患者的异质性和实验精神病理学的发现中显而易见。个性化的途径之一在于分析人类专家和其他参与者的判断和决策，因为他们在追求治疗和康复目标时应对复杂情况。这种分析通过人类决策的计算机模拟得到帮助，这反过来又为开发计算机化临床决策支持系统提供了信息。这激发了一个研究计划，包括数据库、领域本体和问题解决算法的并行开发，以通过人类与智能网络系统的合作实现精神康复的个性化。当前的障碍是证明临床决策（不仅仅是诊断）确实会影响结果。这可以通过支持以下假设来实现：一个具有访问合理全面的临床数据库的能力的人类治疗团队，该数据库可以跟踪患者的状态和治疗反应随时间的变化，比没有这种访问权限的治疗团队在对照实验中取得更好的结果。如果假设可以得到支持，那么不久的将来就会出现原型系统，这些系统可以根据临床评估数据和上下文信息构建综合评估、制定和康复计划。这将导致与人类决策者合作进行精神康复个性化和优化结果的先进系统。
