März K, Hafezi M, Weller T, Saffari A, Nolden M, Fard N, Majlesara A, Zelzer S, Maleshkova M, Volovyk M, Gharabaghi N, Wagner M, Emami G, Engelhardt S, Fetzer A, Kenngott H, Rezai N, Rettinger A, Studer R, Mehrabi A, Maier-Hein L
Department of Medical and Biological Informatics, German Cancer Research Center, Heidelberg, Germany,
Int J Comput Assist Radiol Surg. 2015 Jun;10(6):749-59. doi: 10.1007/s11548-015-1187-0. Epub 2015 Apr 7.
Malignant neoplasms of the liver are among the most frequent cancers worldwide. Given the diversity of options for liver cancer therapy, the choice of treatment depends on various parameters including patient condition, tumor size and location, liver function, and previous interventions. To address this issue, we present the first approach to treatment strategy planning based on holistic processing of patient-individual data, practical knowledge (i.e., case knowledge), and factual knowledge (e.g., clinical guidelines and studies).
The contributions of this paper are as follows: (1) a formalized dynamic patient model that incorporates all the heterogeneous data acquired for a specific patient in the whole course of disease treatment; (2) a concept for formalizing factual knowledge; and (3) a technical infrastructure that enables storing, accessing, and processing of heterogeneous data to support clinical decision making.
Our patient model, which currently covers 602 patient-individual parameters, was successfully instantiated for 184 patients. It was sufficiently comprehensive to serve as the basis for the formalization of a total of 72 rules extracted from studies on patients with colorectal liver metastases or hepatocellular carcinoma. For a subset of 70 patients with these diagnoses, the system derived an average of [Formula: see text] assertions per patient.
The proposed concept paves the way for holistic treatment strategy planning by enabling joint storing and processing of heterogeneous data from various information sources.
肝癌是全球最常见的癌症之一。鉴于肝癌治疗方案的多样性，治疗选择取决于多种参数，包括患者状况、肿瘤大小和位置、肝功能以及既往干预措施。为解决这一问题，我们提出了基于对患者个体数据、实践知识（即病例知识）和事实知识（如临床指南和研究）进行整体处理的治疗策略规划的第一种方法。
本文的贡献如下：（1）一个形式化的动态患者模型，该模型整合了在疾病治疗全过程中为特定患者获取的所有异构数据；（2）一种将事实知识形式化的概念；（3）一个技术基础设施，能够存储、访问和处理异构数据以支持临床决策。
我们的患者模型目前涵盖602个患者个体参数，已成功应用于184例患者。它足够全面，可作为从结直肠癌肝转移或肝细胞癌患者研究中提取的总共72条规则形式化的基础。对于70例患有这些诊断的患者子集，该系统平均每位患者得出[公式：见正文]条断言。
所提出的概念通过实现对来自各种信息源的异构数据的联合存储和处理，为整体治疗策略规划铺平了道路。
