Thanathornwong Bhornsawan
Department of General Dentistry, Faculty of Dentistry, Srinakharinwirot University, Bangkok, Thailand.
Healthc Inform Res. 2018 Jan;24(1):22-28. doi: 10.4258/hir.2018.24.1.22. Epub 2018 Jan 31.
In this study, a clinical decision support system was developed to help general practitioners assess the need for orthodontic treatment in patients with permanent dentition.
We chose a Bayesian network (BN) as the underlying model for assessing the need for orthodontic treatment. One thousand permanent dentition patient data sets chosen from a hospital record system were prepared in which one data element represented one participant with information for all variables and their stated need for orthodontic treatment. To evaluate the system, we compared the assessment results based on the judgements of two orthodontists to those recommended by the decision support system.
In a BN decision support model, each variable is modelled as a node, and the causal relationship between two variables may be represented as a directed arc. For each node, a conditional probability table is supplied that represents the probabilities of each value of this node, given the conditions of its parents. There was a high degree of agreement between the two orthodontists (kappa value = 0.894) in their diagnoses and their judgements regarding the need for orthodontic treatment. Also, there was a high degree of agreement between the decision support system and orthodontists A (kappa value = 1.00) and B (kappa value = 0.894).
The study was the first testing phase in which the results generated by the proposed system were compared with those suggested by expert orthodontists. The system delivered promising results; it showed a high degree of accuracy in classifying patients into groups needing and not needing orthodontic treatment.
在本研究中,开发了一种临床决策支持系统,以帮助全科医生评估恒牙列患者的正畸治疗需求。
我们选择贝叶斯网络(BN)作为评估正畸治疗需求的基础模型。从医院记录系统中选取了1000个恒牙列患者数据集,其中一个数据元素代表一名参与者,包含所有变量的信息及其明确的正畸治疗需求。为了评估该系统,我们将基于两名正畸医生判断的评估结果与决策支持系统推荐的结果进行了比较。
在贝叶斯网络决策支持模型中,每个变量被建模为一个节点,两个变量之间的因果关系可以表示为一条有向弧。对于每个节点,提供一个条件概率表,该表表示在其父母节点的条件下,该节点每个值的概率。两名正畸医生在诊断以及对正畸治疗需求的判断方面高度一致(kappa值 = 0.894)。此外,决策支持系统与正畸医生A(kappa值 = 1.00)和正畸医生B(kappa值 = 0.894)之间也高度一致。
该研究是第一个测试阶段,其中将所提出系统产生的结果与正畸专家建议的结果进行了比较。该系统取得了令人满意的结果;在将患者分为需要和不需要正畸治疗的组方面显示出高度准确性。