Boudis Fabio, Clement Guillaume, Bruandet Amelie, Lamer Antoine
CHU Lille, Service Analyse et Traitement de l'information médicale, F-59000, Lille, France.
Univ. Lille, Faculté Ingénierie et Management de la Santé, F-59000, Lille, France.
Stud Health Technol Inform. 2021 May 27;281:218-222. doi: 10.3233/SHTI210152.
INTRODUCTION: Clinical pathways represents the sequence of interventions from which the patients benefit during their encounters with health care structures. There are several complex issues which make it difficult to represent these pathways (e.g. high numbers of patients, heterogeneity of variables). METHODS: We developed a tool to automate the representation of clinical pathways, from an individual and population points of view, and based on the OMOP CDM. The tool implemented the Sankey diagram in three stages: (i) data extraction, (ii) generation of individual sequence of steps and (iii) aggregation of sequence to obtain the population-level diagram. We tested the tool with three surgery procedures: the total hip replacement, the coronary bypass and the transcatheter aortic valve implantation. RESULTS: The tool provided different ways of visualizing pathways depending on the question asked: a pathway before a surgery, the pathway of deceased patients or the complete pathway with different steps of interest. DISCUSSION: We proposed a tool automating the representation of the clinical pathways, and reducing complexity of visualization. Representations are detailed from an individual and population points of view. It has been tested with three surgical procedures. The tool functionalities will be extended to cover a greater number of use cases.
引言:临床路径代表了患者在与医疗保健机构接触期间从中受益的干预措施序列。存在几个复杂问题使得难以呈现这些路径(例如患者数量众多、变量的异质性)。 方法:我们开发了一种工具,从个体和群体的角度出发,并基于OMOP通用数据模型(OMOP CDM),实现临床路径呈现的自动化。该工具分三个阶段实现桑基图:(i)数据提取,(ii)生成个体步骤序列,以及(iii)聚合序列以获得群体层面的图表。我们用三种外科手术对该工具进行了测试:全髋关节置换术、冠状动脉搭桥术和经导管主动脉瓣植入术。 结果:根据所提问题,该工具提供了不同的路径可视化方式:手术前的路径、死亡患者的路径或具有不同感兴趣步骤的完整路径。 讨论:我们提出了一种实现临床路径呈现自动化并降低可视化复杂性的工具。从个体和群体的角度对呈现进行了详细说明。它已通过三种外科手术进行了测试。该工具的功能将得到扩展以涵盖更多用例。
Stud Health Technol Inform. 2021-5-27
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