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理解患者生成的健康数据以实现可解释的以患者为中心的护理:从“更多”到“更好”的转变。

Making Sense of Patient-Generated Health Data for Interpretable Patient-Centered Care: The Transition from "More" to "Better".

作者信息

Hsueh Pei-Yun Sabrina, Dey Sanjoy, Das Subhro, Wetter Thomas

机构信息

Center for Computational Health, Watson Research Center, Yorktown Heights, New York, USA.

Department of Biomedical Informatics and Medical Education, University of Washington, USA.

出版信息

Stud Health Technol Inform. 2017;245:113-117.

Abstract

The rise of health consumers and the accumulation of patient-generated health data (PGHD) have brought the patient to the centerstage of precision health and behavioral science. In this positional paper we outline an interpretability-aware framework of PGHD, an important but often overlooked dimension in health services. The aim is two-fold: First, it helps generate practice-based evidence for population health management; second, it improves individual care with adaptive interventions. However, how do we check if the evidence generated from PGHD is reliable? Are the evidence directly deployable in realworld applications? How to adapt behavioral interventions for each individual patient at the touchpoint given individual patients' needs? These questions commonly require better interpretability of PGHD-derived patient insights. Yet the definitions of interpretability are often underspecified. In the position paper, we outline an interpretability-aware framework to handle model properties and techniques that affect interpretability in the patient-centered care process. Throughout the positional paper, we contend that making sense of PGHD systematically in such an interpretability-aware framework is preferrable, because it improves on the trustworthiness of PGHD-derived insights and the consequent applications such as person-centered comparative effectiveness in patient-centered care.

摘要

健康消费者的兴起以及患者生成的健康数据(PGHD)的积累,已将患者置于精准健康和行为科学的核心位置。在本立场文件中,我们概述了一个PGHD的可解释性感知框架,这是健康服务中一个重要但常常被忽视的维度。目的有两个:第一,它有助于为人群健康管理生成基于实践的证据;第二,它通过适应性干预改善个体护理。然而,我们如何检验从PGHD生成的证据是否可靠?这些证据能否直接应用于实际应用中?如何根据个体患者的需求在接触点为每个患者调整行为干预措施?这些问题通常需要对PGHD得出的患者见解有更好的可解释性。然而,可解释性的定义往往不够明确。在立场文件中,我们概述了一个可解释性感知框架,以处理在以患者为中心的护理过程中影响可解释性的模型属性和技术。在整个立场文件中,我们认为,在这样一个可解释性感知框架中系统地理解PGHD是更可取的,因为它提高了PGHD得出的见解以及诸如以患者为中心的护理中以人为主的比较效果等后续应用的可信度。

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