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从实践中学习进行个性化:一种基于护理管理记录中患者行为差异反应的护理计划个性化的真实世界证据方法。

Learning to Personalize from Practice: A Real World Evidence Approach of Care Plan Personalization based on Differential Patient Behavioral Responses in Care Management Records.

作者信息

Hsueh Pei-Yun S, Das Subhro, Maduri Chandramouli, Kelly Karie

机构信息

IBM Research, Yorktown Heights, NY, USA.

IBM Watson Health, Dallas, TX, USA.

出版信息

AMIA Annu Symp Proc. 2018 Dec 5;2018:592-601. eCollection 2018.

Abstract

Recent studies documented the importance of individuality and heterogeneity in care planning. In practice, varying behavioral responses are revealed in patients' care management (CM) records. However, today's care programs are structured around population-level evidence. What if care managers can take advantage of the revealed behavioral response for personalization? The goal of this study is thus to quantify behavioral response from CM records for informing individual-level intervention decisions. We present a Behavioral Response Inference Framework (BRIeF) for understanding differential behavioral responses that are key to effective care planning. We analyze CM records from a healthcare network over a 14-month period and obtain a set of 2,416 intervention-goal attainment records. Promising results demonstrate that the individual-level care planning strategies that are learned from practice by BRIeF, outperform population-level strategies, yielding significantly more accurate intervention recommendations for goal attainment. To our knowledge, this is the first study of learning practice-based evidence from CM records for care planning, suggesting that increased patient behavioral understanding could potentially benefit augmented intelligence for care management decision support.

摘要

最近的研究证明了在护理计划中个性化和异质性的重要性。在实践中,患者护理管理(CM)记录显示出不同的行为反应。然而,当今的护理计划是围绕人群层面的证据构建的。如果护理管理者能够利用所揭示的行为反应进行个性化护理会怎样呢?因此,本研究的目的是量化CM记录中的行为反应,以便为个体层面的干预决策提供信息。我们提出了一个行为反应推理框架(BRIeF),用于理解对有效护理计划至关重要的不同行为反应。我们分析了一个医疗网络在14个月期间的CM记录,获得了一组2416条干预目标达成记录。有前景的结果表明,通过BRIeF从实践中学习到的个体层面护理计划策略优于人群层面的策略,在目标达成方面产生了明显更准确的干预建议。据我们所知,这是第一项从CM记录中学习基于实践的证据用于护理计划的研究,表明增强对患者行为的理解可能会为护理管理决策支持的增强智能带来潜在益处。

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