School of Engineering, Auckland University of Technology, New Zealand.
J Clin Monit Comput. 2011 Oct;25(5):339-47. doi: 10.1007/s10877-011-9315-z. Epub 2011 Oct 28.
Humans have a limited ability to accurately and continuously analyse large amount of data. In recent times, there has been a rapid growth in patient monitoring and medical data analysis using smart monitoring systems. Fuzzy logic-based expert systems, which can mimic human thought processes in complex circumstances, have indicated potential to improve clinicians' performance and accurately execute repetitive tasks to which humans are ill-suited. The main goal of this study is to develop a clinically useful diagnostic alarm system based on fuzzy logic for detecting critical events during anaesthesia administration.
The proposed diagnostic alarm system called fuzzy logic monitoring system (FLMS) is presented. New diagnostic rules and membership functions (MFs) are developed. In addition, fuzzy inference system (FIS), adaptive neuro fuzzy inference system (ANFIS), and clustering techniques are explored for developing the FLMS' diagnostic modules. The performance of FLMS which is based on fuzzy logic expert diagnostic systems is validated through a series of off-line tests. The training and testing data set are selected randomly from 30 sets of patients' data.
The accuracy of diagnoses generated by the FLMS was validated by comparing the diagnostic information with the one provided by an anaesthetist for each patient. Kappa-analysis was used for measuring the level of agreement between the anaesthetist's and FLMS's diagnoses. When detecting hypovolaemia, a substantial level of agreement was observed between FLMS and the human expert (the anaesthetist) during surgical procedures.
The diagnostic alarm system FLMS demonstrated that evidence-based expert diagnostic systems can diagnose hypovolaemia, with a substantial degree of accuracy, in anaesthetized patients and could be useful in delivering decision support to anaesthetists.
人类准确且持续地分析大量数据的能力有限。近年来,使用智能监测系统对患者进行监测和进行医学数据分析的能力得到了迅速提高。基于模糊逻辑的专家系统可以在复杂情况下模拟人类的思维过程,这表明其有可能提高临床医生的绩效,并能准确地执行人类不擅长的重复任务。本研究的主要目标是开发一种基于模糊逻辑的临床实用诊断报警系统,用于检测麻醉期间的危急事件。
提出了一种称为模糊逻辑监测系统(FLMS)的诊断报警系统。开发了新的诊断规则和隶属函数(MFs)。此外,还探索了模糊推理系统(FIS)、自适应神经模糊推理系统(ANFIS)和聚类技术,用于开发 FLMS 的诊断模块。通过一系列离线测试验证了基于模糊逻辑专家诊断系统的 FLMS 的性能。训练和测试数据集是从 30 组患者数据中随机选择的。
通过将 FLMS 生成的诊断信息与每位患者的麻醉师提供的诊断信息进行比较,验证了 FLMS 生成的诊断的准确性。使用 Kappa 分析来衡量麻醉师和 FLMS 诊断之间的一致性水平。在检测低血容量时,在手术过程中,FLMS 与人类专家(麻醉师)之间观察到了相当大的一致性。
诊断报警系统 FLMS 表明,基于证据的专家诊断系统可以对麻醉患者的低血容量进行诊断,具有相当高的准确性,并可为麻醉师提供决策支持。